Clinical Analysis Of Uterine Sarcoma In 13 Cases And Review Of The Literature

Objective:To evaluate the epidemiological characteristics、diagnosis, treatment and effect factors of prognosis of the uterine sarcoma。Methods:Review medical records of 13 cases at the First Affiliated Hospital of Kunming Medical University from December 2008 to December 2014. According to the histological type, in this group of cases, there are7 cases of uterine leiomyosarcoma、4 cases of endometrial stromal sarcoma,3 cases of uterine malignant mixed mullerian tumor (including 1 case of leiomyosarcoma semi mixed mullerian tumor). According to the International Union against cancer (UICC) staging system,9 cases in this group of cases are stage I,2 cases are stage Ⅲ,2 cases are stage Ⅳ. Postoperative chemotherapy drugs are Cisplatin, Oxaliplatin、Paclitaxel、 Vincristine、Epirubicin、Cyclophosphamide and so on, the main methods are:TP, PC, PA、VAP Chemotherapy.Results:1、The patients in this group are married women, age range 34-61 years old, the average age was 47.5 years old, including 4 cases of postmenopausal women.2、Clinical manifestation:there are 9 cases of irregular vaginal bleeding,7 cases of abdominal pain and distension patients (including 4 patients with vaginal bleeding),1 case of patients with no obvious symptoms. Gynecological examination of 8 cases of patients with uterine enlargement and lower abdominal mass.3、Supplementary Examination:3 cases of CA125 detected elevated,1 cases of patients with MRI displayed sarcoma of uterus and pelvic metastases,5 cases of ultrasound examination in patients displayed uterine sarcoma to exhaust.4、The pathological examination:3 patients underwent diagnostic curettage pathology prompted uterine sarcoma.5、The misdiagnosis rate:the preoperative misdiagnosis are 10 cases, the misdiagnosis of Myoma of uterus are 5 cases,misdiagnosis endometrial carcinoma are 4 cases, 1 case of misdiagnosis is ovarian tumor.6、Follow up after operation:8 patients were followed up, including 2 cases of recurrence within 1 years after surgery,4 cases died in 2 year,2 cases survived after 2 years.Conclusion:1、The uterine sarcoma is more common in middle-aged women, the majority of patients have irregular vaginal bleeding。There did lack of specific auxiliary examination, ultrasound examination and curettage pathology were helpful to diagnosis, but the incidence of misdiagnosis of the disease is still high.2、Surgery is the effective treatment of uterine sarcoma, and postoperative chemotherapy or radiotherapy may improve the curative effect.3、The prognosis of uterine sarcoma is low,and the recurrence rate is high,so early diagnosis and effective individual treatment are necessary.