低度恶性子宫内膜间质肉瘤41例临床分析.docVIP

低度恶性子宫内膜间质肉瘤41例临床分析 2007年1月第29卷第1期ChinJOncoLJanu!垫:: 低度恶性子宫内膜间质肉瘤41例临床分析 马绍康张宏图吴令英刘丽影李斌 【摘要】目的分析低度恶性子宫内膜问质肉瘤(LESS)的治疗及预后情况,以期对这类肿瘤的 治疗提供参考.方法回顾性分析41例LESS的治疗方法及其对肿瘤复发,患者存活的影响.采用 寿命表法计算生存率.结果41例患者中,24例以不规则阴道出血为主要症状,30例术前诊断为子 宫肌瘤.全部患者均行手术切除,33例术后接受了辅助治疗,包括放疗和(或)化疗.41例患者的 5年和10年生存率分别为87.5%和77.8%.共有18例患者复发,复发率为43.9%,多数位于盆腔, 中位复发时间为26个月,平均复发时间为31个月.保留卵巢功能患者的复发率(66.7%)高于不保 留卵巢功能者(37.5%);术后未接受辅助治疗患者的复发率为87.5%,而术后接受辅助治疗者复发 率为30.3%,二者比较,差异有统计学意义(Plt;0.05).31例接受辅助放疗者中,10例(32.3%)复 发,而未行放疗的10例患者中,有8例(80.0%)复发.18例复发患者的5年生存率为71.8%.结论 LESS预后好,但复发率较高,而且有晚期复发的倾向.术后辅助放疗对减少局部复发有益. 【主题词】子宫内膜间质肉瘤;预后 Treatmentandprognosisoflow-grademalignantendometrialstromalssrcomaMAShao—kang, zHANGHong-tu,WULing—ying,uU一,LIBin.DepartmentofGynecologicalOneology.Caner Ho~iml(Institute),ChineseAcademyofMedwdSciences,PekingnMedwdCollege,Be100021, China Correspondingauthor:MAShao—,E.mail:mskd2@sina.corn 【Abstract】ObjectiveToreviewtheexperienceinthetreatmentoflow.grademalignantendometrial stromalsarcoma.MethodsThedataof41patientswithlow.grademalignantendometrialstromalsal~oma s~callytreatedbetween1982and2004werereviewed.Statisticalanalysiswascarriedoutusingand Kaplan—Meierlifetable.ResultsOfthese41patients,24suffemdfromirregularvagihalbleeding,and30 hadbeendiagnosedtohaveleiomyomabeforetreatment.Thirtypatientsbut11underwentSUrgical managementwithuterusremoved.Thirty—threepatientsreceivedpostoperativeadjuvanttherapyincluding radiationand/orchemotherapy.The5-yearand10一yearactuarialsurvivalWas87.5%and77.8%. respectively.Eighteenpatients(43.9%)developedrecurrentdisease.mostofwhichinthepelvis.rI}le meantimetorecurrencewas31months(range6to78months)witllthemediantimeof26months.The recurrentratewas66.7%forpatientswhoseovarianfunctionWflSreservedversus37.5%forthosewithout reservation.Patientswhoreceivedaajuvanttherapyhadalowerrecurrentrate(30.3%)thanthosewhodid not(87.5%).TherecurrentrateofthepatientstreatedwithpostoperativeadjuvantradiationWfl832.3% (10/31)versus8O%(8/lO)forthosepatientswithout.The5-yearactuarialsur