假定为良性疾病的子宫肉瘤患者手术后的临床病理和生存分析

IF 3.4 2区医学 Q2 ONCOLOGY

BMC Cancer Pub Date : 2024-09-09 DOI:10.1186/s12885-024-12881-8

Tonghui Wang, Hua Yuan, Lihong Li, Hongwen Yao

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引用次数: 0

摘要

目的：研究子宫肉瘤患者的临床病理特征和预后。我们确定了 2004 年 1 月 1 日至 2021 年 1 月 1 日期间，因推测为良性疾病而接受初诊手术后偶然发现子宫肉瘤并到我院接受再次探查以完成手术的所有患者。我们分析了这些患者的临床病理特征和预后。本研究共纳入 95 例患者。在初次手术中，50 例（52.6%，50/95）患者进行了子宫肌瘤剔除术，45 例（47.4%，45/95）患者进行了子宫切除术。所有患者都进行了再次检查，以完成分期手术。分期手术的中位时间为 40 天（15-90 天不等）。29名患者（30.5%，29/95）有残余肉瘤，其中17名患者（17/95，17.9%）的残余子宫上有残余肉瘤，9名患者（9/95，9.5%）有播散性疾病，4名患者（4/95，4.2%）淋巴结阳性。约 40 名患者（42.1%）接受了辅助化疗，55.2%（16/29）和 36.4%（24/66）有/无残余疾病的患者分别接受了辅助化疗（P = 0.087）。中位随访时间为 76.7 个月（IQR：34.8-118.1 个月）。17名患者（17.9%）在再次手术后复发。整个组群的5年无进展生存期（PFS）和5年总生存期（OS）分别为81.7%和92.1%。与无残留肉瘤的患者相比，有残留肉瘤的患者的5年无进展生存期和5年总生存期更短（5年无进展生存期：75.6% 对 84.5%，P = 0.224；5年总生存期：85.5% 对 95.1%，P = 0.224）：85.5%对95.1%，P=0.217）。与无播散性疾病的患者相比，播散性疾病患者的5年OS（62.5% vs. 95.1%，P = 0.007）和5年PFS（64.8% vs. 83.4%，P = 0.153）均较差，但无显著性差异。因假定为良性疾病而接受手术治疗的子宫肉瘤患者生存率较高。有播散性疾病的患者与无播散性疾病的患者相比，5年生存率较低。手术再探查对于切除残余肉瘤和播散性疾病可能很有价值。

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Clinicopathological and survival analysis for patients with uterine sarcoma treated following surgery for presumed benign disease

To investigate the clinicopathological characteristics and prognosis of patients with uterine sarcoma treated following surgery for presumed benign disease. We identified all patients with uterine sarcoma found incidentally after primary surgery for presumed benign disease who presented to our institution and received re-exploration for completion surgery from January 1, 2004 to January 1, 2021. We analyzed the clinicopathological characteristics and prognosis. Overall, 95 patients were included in our study. For the initial surgery, myomectomy was performed in 50 (52.6%, 50/95) patients, hysterectomy was performed in 45 (47.4%, 45/95) patients. All patients were re-explored to complete the staging operation. The median time to the staging surgery was 40 days (range 15–90 days). There were 29 patients (30.5%, 29/95) had remnant sarcomas, with 17 patients (17/95, 17.9%) on the remaining uterus, 9 patients (9/95, 9.5%) had disseminated diseases, and 4 patients (4/95, 4.2%) had positive lymph nodes. About 40 patients (42.1%) received adjuvant chemotherapy, 55.2% (16/29) and 36.4% (24/66) patients with/without remnant diseases received adjuvant chemotherapy, respectively (P = 0.087). The median follow-up duration was 76.7 months (IQR: 34.8-118.1 months). And 17 patients (17.9%) had recurrence following re-exploration surgery. 5-year progression-free survival (PFS) and 5-year overall survival (OS) for the entire cohort was 81.7% and 92.1%, respectively. Patients with remnant sarcomas had a tendency towards a worse 5-year PFS and 5-year OS, compared with those without (5-year PFS: 75.6% vs. 84.5%, P = 0.224; 5-year OS: 85.5% vs. 95.1%, P = 0.217). Patients with disseminated diseases had a worse 5-year OS (62.5% vs. 95.1%, P = 0.007) and non-significantly worse 5-year PFS (64.8% vs. 83.4%, P = 0.153) compared with those without. Patients with uterine sarcoma treated following surgery for presumed benign disease have a favorable survival. Patients with disseminated diseases had a worse 5-year OS compared with those without. Surgical re-exploration may be valuable for removing remnant sarcomas and disseminated diseases.

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来源期刊

BMC Cancer 医学-肿瘤学

CiteScore

6.00

自引率

2.60%

发文量

1204

审稿时长

6.8 months

期刊介绍： BMC Cancer is an open access, peer-reviewed journal that considers articles on all aspects of cancer research, including the pathophysiology, prevention, diagnosis and treatment of cancers. The journal welcomes submissions concerning molecular and cellular biology, genetics, epidemiology, and clinical trials.