32例子宫平滑肌肉瘤的诊治及预后因素

DIAGNOSIS,THERAPY AND PROGNOSTIC FACTORS OF 32 UTERINE LEIOMYOSARCOMAS

目的 研究３２ 例子宫平滑肌肉瘤的诊治及预后因素。 方法 １９６２ 年７ 月～１９９４ 年１０ 月，收治３２例子宫平滑肌肉瘤，其中Ⅰ期１１ 例，Ⅱ期４ 例，Ⅲ期１４ 例，Ⅳ期３ 例，３２ 例均行手术治疗，术后补充化疗１６ 例，补充放疗８ 例，补充化疗加放疗７ 例。 结果 本组病例总的二年及五年生存率分别为５５２％ 及３６５ ％ 。Ⅰ～Ⅱ期的二年及五年生存率为７３３％ 及６４３ ％ ，Ⅲ～Ⅳ期的二年及五年生存率为３５７ ％ 及０ ％ 。 结论 子宫平滑肌肉瘤预后和临床分期、治疗方法、子宫大小、绝经因素等有明显关系，术后辅以化疗和放疗有可能提高生存率。

To investigate the clinical features of 32 uterine leiomyosarcomas.METHODS 32 cases of uterine leiomyosarcoma were studied.Among them,11 cases were in stage Ⅰ,4 stage Ⅱ,14 stage Ⅲ and 3 stage Ⅳ.32 cases were treated by surgery alone,16 cases by surgery plus chemotherapy,8 cases by surgery plus radiation,7 cases by surgery combined with chemotherapy and radiation therapy.RESULTS In the series, the overall 2 and 5 year survival rates were 55.2% and 36% respectively.The 2 and 5 year survival rates for the 15 cases with stage Ⅰ-stageⅡ were 73.3% and 64.3%, for 17 cases with stage Ⅲ-stage Ⅳ were 35.7% and 0%.CONCLUSIONS The clinical stage, treatment methods,uterine size and menopausal status generally are significantly prognostic factors.Postsurgical adjuvant radiotherapy and chemotherapy significantly improve survival.