Current Status of Uterine Leiomyosarcoma in the Tohoku Region: Results of the Tohoku Translational Center Development Network Survey
Current Status of Uterine Leiomyosarcoma in the Tohoku Region: Results of the Tohoku Translational Center Development Network Survey
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DOI：
10.1007/s10147-017-1097-y
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发表时间：
2017-06-01
影响因子：
3.3
通讯作者：
Watanabe, Yoh
中科院分区：
文献类型：
--
作者：
Tokunaga, Hideki;Takahashi, Fumiaki;Watanabe, Yoh
背景：为了准备未来的临床试验，以改善子宫平滑肌肉瘤（ULMS）患者的长期预后，我们在日本东北地区进行了一项多机构调查。方法对2011 - 2014年东北转化研究中心发展网络成员机构进行回顾性队列研究。结果本次调查共登记了31家医院的53例ULMS患者。患者中位年龄为56岁，67.9%的患者绝经后，88.7%的患者表现为0或1，只有6例患者（11.3%）术前有恶性肿瘤证据。尽管只有26.4%的患者进行了腹膜后淋巴结切除术，但64.2%的患者被确定为FIGO 1期疾病；73.6%符合接受完整手术的条件。36例术后化疗患者中，28例（77.8%）接受了多西他赛和吉西他滨联合治疗。最常见的复发部位是肺部，所有入组患者的中位无进展生存期为11.7个月。然而，III期和IV期患者的中位无进展生存期和中位总生存期分别为3.4个月和11.4个月。结论虽然ULMS的手术完成率或最佳手术率较高，但其远期预后较差。为改善ULMS患者的远期预后，应制定有效的术后治疗方案。
Background To prepare for a future clinical trial for improving the long-term prognosis of patients with uterine leiomyosarcoma (ULMS), we conducted a multi-institutional survey in the Tohoku region of Japan.Methods We conducted a retrospective cohort study between 2011 and 2014 in member institutions of the Tohoku Translational Research Center Development Network.Results A total of 53 patients with ULMS were registered in 31 institutions for the present survey. The median patient age was 56 years, 67.9% of the patients were postmenopausal, 88.7% had a performance status of 0 or 1, and only 6 patients (11.3%) showed preoperative evidence of malignancy. Although retroperitoneal lymphadenectomy was performed in only 26.4% of patients, 64.2% patients were identified as having FIGO stage 1 disease; 73.6% were eligible to undergo complete surgery. Among 36 patients who were treated with postoperative chemotherapy, 28 (77.8%) received docetaxel and gemcitabine combination therapy. The most frequent recurrence site was the lungs, and the median progression-free survival of all enrolled patients was 11.7 months. However, the median progression-free survival and the median overall survival in patients with stages III and IV disease were 3.4 and 11.4 months, respectively.Conclusion Although ULMS was associated with a high rate of complete or optimal surgery, the long-term prognosis was poor. Effective postoperative therapy should be developed to improve the long-term prognosis of patients with ULMS.