Clinical analysis of 19 cases of uterine sarcoma / 대한산부인과학회지

OBJECTIVE: The aim is to evaluate the clinical findings of uterine sarcoma we had experienced. METHODS: This study was retrospectively reviewed 19 patients with uterine sarcoma who were managed at Wonju Christian Hospital between September 1982 and May 2003. We analyzed clinical features, type of surgery, adjuvant therapy, three year-survival rate, prognostic factors of uterine sarcoma, and the effects of postoperative chemotherapy and radiotherapy on death. RESULTS: Our study included four histologic types: 8 patients with leiomyosarcoma (42.1%), 5 patients with endometrial stromal sarcoma (26.3%), 4 patients with malignant mixed Mullerian tumor (21.0%), 1 patient with angiosarcoma (5.3%) and 1 patient with both leiomyosarcoma and endometrial stromal sarcoma (5.3%) (Table 1). The cases were classified according to the FIGO staging system. 13 patients (63.2%) had stage I, 2 patients (10.5%) stage II, 2 patients (10.5%) stage III, 3 patients (15.8%) stage IV (Table 1). The three-year survival rate of uterine sarcoma was 53.8%, the most common symptom was abnormal vaginal bleeding. CONCLUSION: Uerine sarcomas are aggressive tumors with poor prognosis, except when the diagnosis is low grade endometrial stromal sarcoma. The effects of postoperative chemotherapy and radiotherapy on death were not statistically significant. This is a retrospective review with small numbers and short periods. Prospective multicentric trials including a statistically evaluable number of patients are necessary.

The comparison of the pregnancy outcomes according to the types of placenta previa / 대한산부인과학회지

OBJECTIVE: To suggest the pregnancy outcome data according to the types of placenta previa in order to establish the optimal management of placenta previa. METHODS: A retrospective review of the clinical records of 179 women delivered with the diagnosis of placenta previa over 25 gestational weeks during the 6-year period from January 1, 1995 to December 31, 2000, at the Wonju Christian Hospital. We divided each groups into total, partial and marginal placenta previa in order to compare pregnancy outcomes. RESULTS: There were significant differences in the numbers of gravida, prior abortion, number of previous cesarean section between marginal and total placenta previa group. There were no significant differences in the gestational weeks at delivery, blood transfusion units, birth weight and placenta/birth weight ratio among each group. Statistically significant frequent hysterectomy in case of partial palcenta previa in comparison to marginal placenta previa was performed. Significant differences of the prior cesarean section (86.4% vs 3.8%) and placenta accreta (45.4% vs 37.5%) were noted between hysterectomy group and no hysterectomy group. CONCLUSION: Previous cesarean section history is strongly associated with cesarean hysterectomy. Women with placenta previa and history of previous cesarean section have more risk of placenta accreta. So, we should prepare sufficiently for cesarean hysterectomy in such cases.