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Background and Purpose: uterine sarcoma is a rare gynecological malignancies, histological type complex, common uterine smooth muscle sarcoma (LMS), endometrial stromal sarcoma (ESS), and Miller pipe uterine malignant mixed tumor (MMMT) . Uterine sarcoma preoperative diagnosis is difficult, misdiagnosis is high, the prognosis is poor. Surgery is the main treatment, but locally aggressive uterine sarcoma, the early stage of metastasis, recurrence rate, adjuvant therapy to reduce recurrence and prolong survival time. This paper summarizes the analysis of the Fourth Hospital of Hebei Medical University for the past 10 years 80 cases of uterine sarcoma clinical and pathological features, treatment and follow-up data, analysis of their prognostic factors to provide clinical data to improve the diagnosis and treatment of uterine sarcoma. Methods: March 1999 to March 2008, the Fourth Hospital of Hebei Medical treatment of 80 cases of uterine sarcoma in patients with clinical and follow-up data. The results were statistically analyzed using SPSS13.0. Results: 1.1 age and menopausal status of the clinical features of the different histological types of 80 patients, with an average age of 50.9 ± 1.3 years, with a median age of 50 years old. The age of onset of the difference was statistically significant (P lt; 0.05) between each histological type high MMMT age of onset, more common in patients over 50 years of age. 32 cases of post-menopausal patients, 21 cases of MMMT, the difference was statistically significant (P lt; 0.05) between each histological type MMMT more common in postmenopausal patients. 1.2 Clinical manifestations and signs of uterine sarcoma clinical manifestations of non-specific, abnormal vaginal bleeding as the first symptom (70%) of the MMMT than LMS to appear abnormal vaginal bleeding, vaginal discharge were more common, and the difference was statistically significant (P lt ; 0.05), MMMT, LMS, respectively, compared with ESS, the difference was not statistically significance (P gt; 0.05). Uterine size no difference between the various histological types (P gt; 0.05). 1.3 Preoperative preoperative diagnosis and laboratory examinations were confirmed 17 cases, of which the MMMT diagnosed 12 cases of preoperative diagnosis rate (P lt; 0.05). Curettage preoperative diagnosis rate among various histological types, tumor markers elevated no difference (P gt; 0.05). Ultrasound prompted vicious placeholder misdiagnosed as uterine fibroids, the difference was statistically significant (P lt; 0.05) between each histological type, prompt malignant placeholder MMMT more common, misdiagnosed as uterine fibroids LMS, ESS than more common; rich flow signals between each histological type showed no significant differences (P gt; 0.05). 1.4 clinical stage and tumor size, histologic type of clinical stage no difference (P gt; 0.05), histological type, tumor size, no difference (P gt; 0.05). 2 follow-up results and uterine sarcoma survival rate of all 80 patients follow-up, follow-up rate of 100%. Shortest follow-up time of one month and a maximum of 111 months. 1 year, 2 years, 5-year overall survival rates were 79.9%, 69.9% and 66%, respectively. LMS 34 cases, 1 year, 2 years, 5-year survival rates were 91.2%, 84.7%, 81%; the ESS 15 cases, 1 year, 2 years, 5-year survival rates were 100%, 100%, 87.5%; The MMMT 31 cases, 1 year, 2 years, 5-year survival rates were 61.3%, 37.4%, 37.4%. Ⅰ 55 cases, 1 year, 2 years, 5-year survival rates were 92.5%, 87.6%, 84.7%; Ⅱ 1 case, 1-year, 2-year, 5-year survival rates were 100%, 0%, 0 ; Ⅲ 15 cases, 1 year, 2 years, 5-year survival rates were 53.3%, 38.9%, 38.9%; the Ⅳ 9, 1 year, 2 years, 5-year survival rates were 33.3%, 11.1% , 11.1%. Recurrence rate between the different histological types, the relapse rate in patients with different clinical stages differences no difference (P gt; 0.05); difference was statistically significant (P lt; 0.05) relapse rate in patients with different treatment methods, surgery after adjuvant chemotherapy can reduce the recurrence rate. 4 uterine sarcoma prognostic factors of 4.1 single factor analysis Univariate analysis showed that age, menopausal status, uterine size, histological type, tumor size, clinical staging, treatment, surgery is a factor affecting the prognosis of uterine sarcoma. 4.2 multi-factor analysis of univariate analysis using the Cox proportional hazards model, significant prognostic factors line multi-factor analysis, the results showed that menopausal status, clinical stage were independent prognostic factors in uterine sarcoma. Conclusion: The histological type the MMMT age of onset of high, more common in patients over the age of 50 and after menopause. 2 abnormal vaginal bleeding is the most common clinical manifestations of uterine sarcoma, MMMT than LMS appear abnormal vaginal bleeding, vaginal discharge were more common. The the 3 histological type, the the MMMT preoperative diagnosis rate higher curettage in the preoperative diagnosis rate between each histological type and tumor markers elevated no difference. The Doppler ultrasound MMMT patients with malignancy placeholder meaningful. 4 studies in patients with uterine sarcoma 1 year, 2 years, 5-year overall survival rates were 79.9%, 69.9% and 66%, respectively. The histological types ESS higher survival rate, higher clinical stage Ⅰ of survival. 5 Surgery is the treatment of uterine sarcoma, but enlargement surgery does not improve survival in patients with uterine sarcoma. 6 post-operative adjuvant chemotherapy can improve overall survival and Ⅲ patient survival, reduce the relapse rate. 7 age, menopausal status, uterine size, histological type, tumor size, clinical stage, treatment, surgery affect the prognostic factors of uterine sarcoma. Menopausal status, clinical stage were independent prognostic factors in uterine sarcoma.
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