Background Uterine sarcoma is a rare malignancy of women and fewer uterine sarcomas are detected preoperatively. The reported incidence of preoperatively diagnosed uterine sarcoma (PDUS) was 0.07%. This study aims to identify the prevalence of unexpected uterine sarcoma (UUS) after operation for presumed leiomyoma and compare clinical outcomes after primary therapy. Methods A retrospective study was performed evaluating all uterine sarcoma diagnosed in Tianjin Central Hospital of Gynecology and Obstetrics between May 2011 and July 2016.We used the χ2 and T tests to assess the incidence and clinical features of patients. The Kaplan–Meier method was used to calculate disease-related survival. Results The study retrospectively analyzed 6625 patients with uterine fibroids and found 45 UUS patients and 21 patients of PDUS. The incidence of UUS is (45/6625) 0.67%. The incidence of UUS in patients undergoing total hysterectomy was higher undergoing tumor resection (P < 0.001); the age of UUS is younger than PDUS (P = 0.046); the differences in menopausal status and primary complaints between the two groups are not statistically significant. The PDUS group had more patients with Stage II and III sarcomas than the UUS group (P < 0.001); the duration of symptoms in the PDUS group was longer than in the UUS group (P = 0.033). The 5-year overall survival (OS) rate of the UUS group (77.7%) is higher than the PDUS group (46.3%) (P < 0.001). Conclusions The incidence of UUS is low. UUS has a younger age of onset, shorter history of the disease, earlier clinical stage, and better prognosis.
Objective: To identify the optimal weight gain at the end of the second trimester. Design: This was a population-based cohort study from the antenatal care system in Tianjin, China. We calculated gestational weight gain (GWG) based on the weight measured in the first trimester and the end of the second trimester. Restricted cubic spline analysis was performed to model the possible nonlinear relationships between GWG and adverse outcomes. The optimal GWG was defined as the value of the lowest risk. Noninferiority margins and the shape of the spline curves identified the recommended ranges in Chinese-specific body mass index categories. Setting: Tianjin Maternal and Child Health Cohort Participants: Singleton pregnant women aged 18-45 years Results: In total, 69859 pregnant women were included. Adverse outcome (including stillbirth, preterm birth, hypertensive disorders of pregnancy, gestational diabetes mellitus, small and large for gestational age) was significantly associated with GWG at the end of the second trimester. The risk score was non-linearly correlated with GWG in the underweight, normal weight, and overweight groups. GWG at the end of the second trimester should not be less than 7 kg in underweight group. For most normal-weight women, a GWG of about 8 kg is optimal. Pregnant women who are overweight should not have a GWG of more than 9 kg. We advised women with overweight and obesity to keep positive growth of GWG (> 0 kg) in the first and second trimesters. Conclusions: According to the comprehensive adverse maternal and infant outcomes, we recommend the optimal GWG at the end of the second trimester. This study may provide a considerable reference for weight management.
Background To investigate the clinical manifestations and treatment of unexpected uterine sarcoma (UUS) and thus to improve the preoperative diagnostic rate and to reduce the risk of unexpected tumor dissemination. Methods The study retrospectively analyzed 45 UUS patients and 21 patients of preoperatively diagnosed uterine sarcoma (PDUS). We used the χ2 and T tests to assess the incidence and clinical features of patients. The Kaplan-Meier method was used to calculated disease related survival. Results The incidence of UUS is (45/6625) 0.67%.The incidence of UUS in patients undergoing total hysterectomy was higher than that in patients undergoing tumor resection (P < 0.001); The age of UUS is younger than that of PDUS (P = 0.046); The differences in menopausal status and primary complaints between the two groups are not statistically significant (P > 0.05).PDUS group had more patients with Stage II and III sarcomas than that of UUS group(P < 0.001); Duration of symptoms in PDUS group was longer than that of UUS group( P = 0.033). The 5-year overall survival(OS) rate of UUS group(77.7%) is higher than that of PDUS group(46.3% ) (P < 0.001). Conclusions The incidence of UUS is low. UUS has younger age of onset, shorter history of disease, earlier clinical stage, and better prognosis.
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