早期子宫平滑肌肉瘤治疗方式的研究进展

子宫平滑肌肉瘤(uterine leiomyosarcoma, uLMS)临床罕见。其临床表现缺乏特异性，多数uLMS通常在术中或术后经组织病理得以诊断。由于uLMS恶性程度高、侵袭性强，即便确诊时尚处临床早期，疾病复发转移率及患者死亡率仍然较高，预后不容乐观。现有循证医学数据表明，FIGO分期是其最重要的独立预后因子。因此，在这个讲求精准医学与个体化治疗的时代，应予不同期别uLMS以不同的治疗策略。对于I期uLMS而言，手术仍是首选的治疗方式，但在全子宫切除的同时是否应切除双侧卵巢及是否应行淋巴结清扫仍尚存争议；而其他疗法如化疗、放疗、免疫治疗等亦对I期uLMS作用不一。本文将综述I期uLMS的治疗方式，分析其临床应用现状与最新研究进展，以期为临床诊疗提供参考。

Research progress of treatment methods for uterine leiomyosarcoma at early stage

Uterine leiomyosarcoma(uLMS) is a rare subset of gynecologic malignancies without characteristic symptoms.Preoperative diagnosis of uLMS is challenging and often made at time of surgery.Due to its extremely aggressive malignancy，the recurrent rate and mortality of patients with uLMS are poor，even the cases are diagnosed at early stage.Multiple evidence has demonstrated that FIGO stage is the most crucial prognostic factor regarding uLMS.Herein，optimal and precise treatment methods are warranted for uLMS at corresponding stages.With respect to early stage uLMS，hysterectomy is still the fundamental therapy，yet the routine oophorectomy and lymphadenectomy remains controversial.The curative effect of other managements like chemotherapy，radiotherapy，immunotherapy，etc.shows diversity.This review will go on detail treatment methods，and highlight their application status and research progress.