65例复发及转移的子宫肉瘤分析

A clinical analysis of 65 uterine sarcomas with recurrence or metastasis

1960年5月至1994年4月，我院共收治153例子宫肉瘤。治疗后65例发生局部复发或远处转移，复发转移率42．5％平均复发转移时间12．9个月，中位时间7个月。76．9％的病人在2年内复发，单纯局部复发23例（354％），单纯远处转移28例（43．1％），局部加远处转移14例（21．5％）。本文分析了复发转移特点及复发有关因素。手术是子宫肉瘤主要治疗手段，术后输以放疗可降低盆腔复发率，尤其是内膜间质肉瘤，而术后加化疗未能降低远处转移率。复发转移与病理类型无关，与病变范围有一定关系。复发后积极治疗对延长病人生命有明显意义。

A series of 65 uterine sarcomas with recurrence or metastasis were analysed retrospectively. It made up 42.5% of 153 uterine sarcomas treated at Cancer Hospital of CAMS and PUMC, from May 1964 to April 1994. The average interval of recurrence or metastasis was 12.9 months, the median duration was 7 months after treatment. 76.9%, of patients had less than 2 years. 23 cases (35.4%) were regional recurrent alone, 28(43.1%) distant metastasis alone. 14 cases (21.5%) had both. It is shown that histologic type and disease 8tage are not statistically signincant innuence to the recurrence or metastasis.Adjuvant radiotherapy can reduce the pelvie recurrence, but adjuvant chemotherapy can not reduce the distant spread. Active retreahoent for recurrence can prolong survival of patients signilicantly.