Analysis Of Prognostic Factors Of Uterine Sarcoma

Purpose:Uterine sarcoma is a kind of rare malignant tumor of female reproductive system arising from stroma,connective tissue,smooth muscle of uterus.It had all kinds of tissue morphology containing leiomyosarcoma ( LMS),endometrial stromal sarcoma ( ESS) and malignant mullerian mixed tumor (MMMT). Etiology of those carcinoma were uncertain up to now and early diagnosis was difficult characterized by a high tendency to spread and recur and metastasize.So treatment procedures had not gained a significant progress. Moreover factors affecting the prognosis of uterine sarcoma were controversial such as ages,menopausal states,surgery_pathology stages,pathologic type,treatment mode,immersion depth and malignant grade.The objective of the experiment was to analyse the prognostic factors of uterine sarcinomas and guide the ciinical treatment.Method: Retrospective analysis of 107 uterine sarcoma cases registered in the 8 year period 1996–2004 in tumor hospital of ShanXi.Patient ages ranged from 26 to 83, among which there were 41 cases whose ages were less than 50(38.32%), 66 cases were more than 50(61.68%),average ages were 58,medium ages were 61.Tthere were 74 cases with leiomyosarcoma (69.2%), 12 with malignant endometrial interstitial sarcomas(11.2%), 21 with malignant Mullerian mixed tumor (19.6%). There wer 43 cases(40.2%) without menostasis,64 cases (59.8 %) were menopaused until diagnosis. According to Union Internationale Contre le Cancer (UICC) staging, 66 cases were on stageⅠ(61.68%), 2 5 cases were on stageⅡ( 23.36%), 12 cases belonged to sgeⅢ(11.21%), and 4 cases belonged to stageⅣ(3.74%). In treatment 74 patients were treated by hysterectomy, bilateral salpingo-oophorectomy and pelvic lymphadenectomy; 20 of them by hysterectomy and bilateral salpingo-oophorectomy. after operation, 64 of them were treated by combination chemotherapy of time from 1 to 6 period of treatment, including cyclophosphamide,cisplatin and doxorubicine via vein injection.13 patients were treated by radiotherapy. 97 patients were followed up and single factors were analysed using logistic regression. Significant factors were analysed by COX mode,and then survival rate was compared by Kaplan-Meier.Result:1 Ages,menopausal states,surgery_pathology stages,pathologic type,immersion depth were significant prognostic indicators in univariate analysis.2. Multivariate analysis of prognostic factors for uterine sarcoma with COX mode showed that prognostic factors were related to Age,surgery_pathology stages.3 Compared the survival rate of ages and surgery_pathology stages. Medium survival duration of patients whose ages were less than 50 were 49.51 months.Ages more than 50 were 40.91 months.There were significant different in survival rate (P=0.047).Medium survival duration of patients on stageⅠwere 55.66 months, stageⅡ,ⅢandⅣwere 37.17,32.06,18.93 months respectively .survival rate were obvious different (P=0.000)in each stages.Conclusions These results demonstrated that ages and surgery_pathology stages were important prognostic factors affecting prognosis of uterine sarcoma. survey,chemotherapy and radiation therapy would not improve the prognosis of patients. radiation therapy after operation could only reduce recurrence and not control metastasis and enhance survival rate.Therapy of uterine sarcinoma was a difficult problem .Only diagnosis and treatment as soon as possible could improve the survival rate of the patients. The clinical effect of the experiment required another confirmation because the research was performed retrospectively.