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1、子宫内膜间质肉瘤术后辅助治疗方式探讨金滦a,潘凌亚a,王雪卿a,戴志琴a,黄慧芳a,郭丽娜b,连利娟a摘耍：目的探讨辅助治疗对子宫内膜间质肉瘤(ESS)复发及牛存的影响。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索多因索分析。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
2、诊吋间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苦延缓复发(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苦延长患者的无瘤牛存期(P=0.027)o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。关键词:辅助治疗；子宫内膜间质肉瘤；内分泌治疗Impactofadjuv
3、anttreatmentmodalitiesonthemanagementofpatientswithendometrialstromalsarcoma・JINYing,PANLing-ya,WANGXue-qing,DAIZhi-qin,HUANGHui-fang,GUOLi-na,LIANLi-juan.PekingU-nionMedicalCollegeHospital,ChineseAcademyofMedicalScience,Beijing100730,ChinaAbstract:ObjectiveToevaluate
4、theimpactofadjuvanttreatmentonthesurvivalofendometrialstromalsarcoma(ESS).MethodsThirty-sevenESSpatientsweretreatedatPekingUnionMedicalCol1egeHospital(PUMCH)between1983and2005・Thedemographic,treatmentandsurvivalinfomiationwereretrospectivelyreviewed.Datawereanalyzedus
5、ingCoxproportionalhazardsregression.ResultsThemedianageofthepatientswas42years(18〜Glyears).24of37patients(64.9%)weregivenbilateralsalpingo-oophoreclomy(BSO)duringtheprimarysurgeryand24paticntsre-ceivedadjuvanthormonaltherapy,radiationorchemotherapyafteroperation.Witht
6、hemedianfollow-uptime78months(12〜393months),17patients(45.9%)developeddiseaserecurrenceandthemediandiseasefreesurvival(DFS)was122.1months,onlyonepatientdiedofthedisease.Tnthemultivariateanalysis,themajordeterminantsofDFSwereBSO(P=0.001).Patient'sage,menstrualstatus,FI
7、GOstagingandadjuvanttreatmenthadnosignificantimpactontheDFS,whilehormonaltherapyaftertheprimarysurgerycouldprolongtheDFSsignificantly(P=0・027)・ConclusionESSisararekindofuterinemalignancy.BSOduringtheprimarysurgeryandappropriateadjuvanttreatmentespeciallyhormonaltherap
8、ycouldprolongtheDFSsignificantly.Keywords:adjuvanttreatment;endometrialstromalsarcoma;hormonaltherapy1资料与方法1.1对象和分组回顾性收集自198
