外阴转移性肿瘤78例临床报告  

Metastatic Tumors of the Vulva: a Report of 78 Cases

作　　者：晁红霞[1] 孙建衡[1] 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤医院妇瘤科

出　　处：《中华妇产科杂志》1999年第5期297-300,共4页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的了解外阴转移性肿瘤的临床特点，探讨其诊断及治疗方式。方法回顾性分析１９５８～１９９５年收治的７８例外阴转移性肿瘤患者，其中宫颈癌转移６１例（７８．２％），尿道癌转移５例，阴道癌转移４例，子宫内膜癌转移３例，乳腺癌转移２例，卵巢癌、直肠癌、恶性淋巴瘤转移各１例。结果患者中位年龄５５岁，７５．６％（５９／７８）转移瘤在原发肿瘤诊断之后的１５天至１８年发现，中位间隔时间为２．５年，６１．５％（４８／７８）外阴转移同时合并原发部位复发或转移，其中原发部位复发为３５．４％，腹股沟淋巴结转移为４５．８％，锁骨上淋巴结转移为８．３％，盆腔转移为８．３％，肝、肺、骨转移为１２．５％。治疗方式以放疗为主或结合手术、化疗。外阴转移后１年，３年及５年的生存率分别为６５．４％，２９．５％及１６．７％，生存１０年以上者３例。结论外阴转移性肿瘤预后不佳，综合治疗可改善预后。Objective To study the clinical characteristics, diagnosis and reasonable therapy for metastatic tumors of vulva. MethodsZSeventy eight cases with metastatic tumors of the vulva were retrospectively reviewed. The cervical carcinoma was the most frequent primary site (61 cases), followed by the urethra (5 cases), vagina (4 cases), endometrium (3 cases), breast (2 cases), ovary (1 cases), rectum carcinoma (1 cases) and malignant lymphoma (1 cases). Results The median age of this series was 55. 75.6%(59/78) of the patients subsequently developed vulvar metastasis from 15 days to 18 years after the primary tumors diagnosed, the median interval was 2.5 years. 61.5%(48/78) patients combined with primary site recurrence or other place metastasis, primary site recurrence were 35.4%, inguinal lymph node metastasis 45.8%, supraclavicular lymph node metastasis 8.3%, pelvic metastasis 8.3% and hematogenous metastasis 12.5% (liver, lung, skeleton). Radiotherapy was the main therapeutic approch, some cases combined with surgery and/or chemotherapy. The overall 1 year ,3 years and 5 years survival rates after vulvar metastatic occurrence were 65.4%, 29.5% and 16.7% respectively. Conclusions The prognosis of the vulva metastatic tumors was poor. Radiotherapy combine with surgery and/or chemotherapy can improve the survival.

关 键 词：外阴肿瘤 肿瘤转移 综合疗法 预后 

分 类 号：R737.35[医药卫生—肿瘤] R73－37[医药卫生—临床医学]