- Individualized treatment program for uterine sarcoma patients, taking into consideration the molecular-biological features of the tumor
Individualized treatment program for uterine sarcoma patients, taking into consideration the molecular-biological features of the tumor
HEALTH OF WOMAN. 2018.5(131):26–30; doi 10.15574/HW.2018.131.26
Sukhin V. S.
SI «Institute of Medical Radiology» SP Grigoriev National Academy of Sciences of Ukraine », Kharkiv
The objective: analysis of the efficacy of individualized antiblastome treatment, based on the expression of biological tumor markers.
Materials and methods. The study is based on our own clinical observations of 116 uterine sarcoma patients stage I–II (T1–2NхM0), who underwent treatment in SI “Grigoriev Institute for Medical Radiology of NAMS of Ukraine” from 1993 to 2018. All the patients were divided into two groups: group 1 consisted of 48 patients (treatment period is 1993-2009), group 2 – 68 patients (treatment period is 2010-2018). The treatment efficacy of patients in group 1 was analyzed retrospectively. The antiblastome therapy program for patients in group 2 was determined based on tumor malignancy grade, according to the data of immunohistochemical analysis – coexpression of the estrogen and progesterone receptors, Bcl-2, p53, MMP-9. The effectiveness of treatment of patients in group 2 is monitored in a continuous observation mode.
Results. The distribution of patients by stages in group 1 was as follows: Stage I – 31 patients (64.6%), II – 17 patients (35.4%). In 20 (41.7%) of them there were observed relapsed disease. Group 2 has accounted 60 patients (88.2%) with stage I and 8 patients (11.8%) with stage II. In 16 (23.5%) of these patients there was detected relapsed disease. The relapsed disease was observed within the first 2 years in 85.0 and 81.2% of cases in 1 and 2 groups, respectively. The 3- and 5-year survival rate for patients with stage I in group 1 were 71.0 and 67.7% vs. 80.0 and 78.3% in group 2, respectively. That is, the relapse-rate was decreased by 1.8 times – from 41.7 to 23.5%: at stage I – by 1.5 times (from 32.3 to 21.7%), and at stage II – by 1.6 times (from 58.8 to 37.5%).
Conclusions. Individualized approach to antiblastome treatment of uterine sarcoma patients stages I-II, based on the levels of malignancy greade, according to the data of immunohistochemical analysis, contributed the credible decrease of the relapse-rate. The antiblastome therapy should be administered individually, according to the tumor molecular profile, that will increase the disease-free survival and improve patients quality of life.
Key words: uterine sarcoma, antiblastome therapy, immunohistochemical analysis, relapse of disease, patients survival.
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