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目的 了解影响子宫肉瘤预后的有关因素。方法 对 134例患者的临床资料进行回顾性分析。结果 134例患者总的2年、5年生存率分别为 5 4 .4 4 %和 4 3.6 0 % ,复发率为 5 8.96 % (79/ 134)。单因素分析显示 :(1)年龄 <5 0岁者预后好于年龄≥5 0岁者 (P =0 .0 0 0 1)。 (2 )患者的绝经状态与预后有关 ,未绝经者生存率高于已绝经者 (P =0 .0 0 0 1)。 (3)生存率与手术病理分期有关 ,Ⅰ、Ⅱ期患者的生存率高于Ⅲ ,Ⅳ期患者 (P =0 .0 0 5 6 )。 (4)生存率与病理类型有关 ,MMMT患者的生存率低于LMS和ESS (P =0 .0 0 11)。 (5 )扩大手术范围并不能改善患者的生存率 (P >0 .0 5 )。 (6 )手术后辅助动脉灌注化疗能改善患者的预后 (P =0 .0 0 8)。多因素分析显示 :仅绝经状态、手术分期和辅助化疗三个因素与患者的预后有关 ,其中手术分期是影响患者预后的最重要因素 (P =0 .0 0 0 4 )。结论 绝经状态、手术分期和术后辅助化疗是影响患者生存率的三个独立因素。辅助化疗(经盆腔动脉灌注化疗药物 )不仅能减少复发 ,而且能改善患者的生存率。
Objective To understand the prognostic factors of uterine sarcoma. Methods The clinical data of 134 patients were retrospectively analyzed. Results The overall 2-year and 5-year survival rates of 134 patients were 54.44% and 4.36% respectively, with a recurrence rate of 5 8.96% (79/134). Univariate analysis showed that: (1) The prognosis of patients younger than 50 years was better than those of patients over 50 years of age (P = 0.0101). (2) The patient’s menopause status is related to the prognosis. The survival rate of non-menopausal patients is higher than that of the menopause (P = 0.00001). (3) The survival rate was related to the pathological stage of surgery. The survival rates of patients in stage I and II were higher than those in stage III and IV (P = 0.0606). (4) The survival rate was related to the pathological type. The survival rate of MMMT patients was lower than that of LMS and ESS (P = 0.010). (5) Expanding the scope of surgery does not improve the survival rate of patients (P> 0.05). (6) Postoperative adjuvant arterial infusion chemotherapy can improve the prognosis of patients (P = 0.080). Multivariate analysis showed that only menopausal status, surgical staging and adjuvant chemotherapy were related to the prognosis of patients, of which surgical stage was the most important factor (P = 0.0004). Conclusions The menopausal status, surgical staging and postoperative adjuvant chemotherapy are three independent factors affecting the survival rate of patients. Adjuvant chemotherapy (chemotherapy with pelvic artery infusion) not only reduces recurrence but also improves patient survival.