子宫肉瘤预后分析

Prognostic factors related to uterine sarcoma

目的探讨影响子宫肉瘤患者预后的相关因素。方法回顾性分析随访资料完整的子宫肉瘤患者83例,单因素及多因素回归分析讨论临床病理特征与患者5年总生存率的关系。结果所有患者中位数随访时间为63(13~120)个月。83例患者1、3和5年总生存率分别为91.6%、65.1%和44.6%,5年复发率为51.8%。18例行二次分期手术的患者中10例复发,5年总生存率为45.5%。各病理类型分组中,行二次手术的患者与所有患者的5年总生存率比较,差异均无统计学意义(均P>0.05)。单因素分析显示,患者5年总生存率在肿瘤直径、肿瘤标志物糖类抗原125(carbohydrate antigen 125,CA125)水平、脉管内癌栓情况、淋巴结转移情况、国际妇产科协会(Federation International of Gynecology and Obstetrics,FIGO)分期和病理类型方面比较,差异均具有统计学意义(均P<0.05)。Cox回归分析显示,肿瘤大小(RR=1.89,95%CI:1.08~3.01,P=0.041)、FIGO分期(RR=2.21,95%CI:1.51~3.23,P<0.01)和脉管内癌栓(RR=2.42,95%CI:1.53~3.48,P=0.001)为子宫肉瘤预后的独立危险因素。结论肿瘤大小、FIGO分期和脉管内癌栓情况为子宫肉瘤预后的独立危险因素。

Objective To investigate the prognostic factors of patients with uterine sarcoma.Methods The data of 83 patients with uterine sarcoma and completed follow-up were retrospectively analyzed.Univariate and multivariate regression analysis were used to investigate the relationship between clinical pathological features and five-year overall survival.Results The median follow-up time for all patients was 63(range 13-120)months.1-,3-and 5-year overall survival rates of all patients were 91.6%、65.1%and 44.6%,and the 5-year recurrence rate was 51.8%.Among the 18 patients undergoing second stage surgery,10 had recurrence and the 5-year overall survival rate was 45.5%.Grouped in various pathological types,the 5-year overall survival rates of all patients and those with second stage surgery were not significantly different(all P>0.05).Univariate analysis showed that tumor size,carbohydrate antigen 125(CA125)level,vascular invasion,lymph node metastasis,International Federation of Gynecology and Obstetrics(FIGO)stage and pathological type were the main factors affecting the prognosis(all P<0.05).Cox regression analysis showed that tumor size(RR=1.89,95%CI:1.08-3.01,P=0.041),FIGO stage(RR=2.21,95%CI:1.51-3.23,P<0.01)and vascular invasion(RR=2.42,95%CI:1.53-3.48,P=0.001)were independent risk factors for prognosis of uterine sarcoma.Conclusions Tumor size,FIGO stage and vascular invasion are independent risk factors of the prognosis of uterine sarcoma.