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目的探讨辅助治疗对子宫内膜间质肉瘤(ESS)复发及生存的影响。方法回顾性分析自1983-2005年于北京协和医院治疗的37例ESS的病例资料,记录人口统计学信息、诊断及治疗信息,采用SPSS11.5软件Cox回归分析进行肿瘤复发相关因素多因素分析。结果 37例患者的中位年龄为42岁(18～61岁),初次手术时有24例(64.9%)患者切除了双侧附件,术后有24例(64.9%)接受了放疗、化疗、内分泌治疗或联合的辅助治疗。中位随诊时间78个月(12～393个月),17例(45.9%)患者在随访过程中肿瘤复发,中位复发时间为122.1个月,1例患者死亡。与肿瘤复发相关的多因素分析显示手术切除双侧卵巢可显著延缓复发(P=0.001),而患者年龄、绝经状况、FIGO分期及术后是否辅助治疗对肿瘤复发无显著性影响,但初次手术后给予内分泌治疗可显著延长患者的无瘤生存期(P=0.027)。结论 ESS是一种罕见的子宫恶性肿瘤,初次手术时行双附件切除并进行适当的辅助治疗特别是内分泌治疗可显著延缓复发。
Objective To investigate the effect of adjuvant therapy on the recurrence and survival of endometrial stromal sarcoma (ESS). Methods The data of 37 cases of ESS treated in Peking Union Medical College Hospital from 1983 to 2005 were retrospectively analyzed. Demographic information, diagnosis and treatment information were recorded. Cox regression analysis was used to analyze multivariate analysis of relapse-related factors. Results The median age of 37 patients was 42 years old (18 to 61 years). In the first operation, 24 cases (64.9%) had bilateral accessory resection and 24 cases (64.9%) received radiotherapy and chemotherapy after operation. Endocrine therapy or combined adjuvant therapy. The median follow-up time was 78 months (range, 12 to 393 months). Tumor recurrence was observed in 17 (45.9%) patients during follow-up. The median time to recurrence was 122.1 months and 1 patient died. Multivariate analysis showed that surgical resection of both ovaries significantly delayed the recurrence (P = 0.001). However, the age, menopausal status, FIGO stage and whether postoperative adjuvant therapy had no significant effect on tumor recurrence. However, the first surgery After giving endocrine therapy can significantly extend the patient’s disease-free survival (P = 0.027). Conclusion ESS is a rare malignant tumor of the uterus. When the first operation is performed, double adjuvant resection and appropriate adjuvant therapy, especially endocrine therapy, can significantly delay the recurrence.