Analyze The Clinical Characteristics And Prognosis Factors For Patients With Uterine Smooth Muscle Tumors, Uterine Atypical Leiomyoma And Uterine Leiomyosarcoma

Objective: To analyze the clinical characteristics and prognosis factors of Uterine smooth muscle tumors, Uterine atypical leiomyoma and Uterine leiomyosarcoma. And to study the impact of uterine morcellation on unsuspected uterine leiomyosarcoma.Methods: The clinical data of 2528 patients with preliminary diagnosis of uterine fibroids and 13 patients who were uterine leiomyosarcoma received surgical treatment admitted to the Fourth Hospital of Hebei Medical University from January 2009 to December 2014 were analyzed retrospecttively. Combined with the data of cases, and then by telephone, short message or the letters learn the present condition of the patients. The effects of clinical characteristics upon survival rate and outcomes were analyzed by SPSS21.0.Results: The uterine smooth muscle tumors, uterine atypical leiomyoma, uterine leiomyosarcoma patients' average age was 45.49±7.075 years old, 43.65±7.409 years old, 51.06±9.74 years old respectively. The median age of diagnosis was later in the patients with uterine leiomyosarcoma than those with uterine smooth muscle tumors and uterine atypical leiomyoma. In 383 of 2142 patients of uterine smooth muscle tumors by laparoscopic myomectomy,among them 22(22/383=5.74%)patients recurrenced, aftered surgical again, all cases were still uterine smooth muscle tumors; In 378 of 2142 patients of uterine smooth muscle tumors by abdominal myomectomy, among them,14(14/378=3.70%)patients recurrenced, aftered surgical again, all cases were still uterine smooth muscle tumors. In 10 of 373 patients of uterine atypical leiomyoma recurrenced, 6 of them by laparoscopic myomectomy, the rest of them by abdominal myomectomy,among them, the additional surgical postoperative pathological were still uterine atypical leiomyoma had 7 patients, and the another 2 patients were uterine smooth muscle tumors, but 1 patient malignant changed to uterine leiomyosarcoma. Uterine smooth muscle tumors and uterine atypical leiomyoma may recurrence or malignancy. The malignant change rate of uterine atypical leiomyoma was 0.27%. The 1-year, 2-year, 5-year overall survival rate of uterine leiomyosarcoma patients was 80.4%, 62.5%, 43.6% respectively. Age, diagnosis time, and additional surgery were independent poor prognostic factors for uterine leiomyosarcoma patients.The surgical approach(by laparoscopy or laparotomy), surgical method(whether to keep the bilateral adnexa; whether to remove the lymph node of pelvic),FIGO stage and adjuvant chemotherapy have no statistically significant effects on the survival rate of the uterine leiomyosarcoma patients.Conclusion: The median age of diagnosis is late in the patients with uterine leiomyosarcoma to those with uterine smooth muscle tumors and uterine atypical leiomyoma. Uterine smooth muscle tumors and uterine atypical leiomyoma may recurrence or malignancy. The malignant change rate of uterine atypical leiomyoma was 0.27%. Age, diagnosis time and additional surgery are major independent affect factors for the survival rate of uterine leiomyosarcoma patients. The surgical approach, surgical method,FIGO stage and adjuvant chemotherapy have no statistically significant effects on the survival rate of the uterine leiomyosarcoma patients.