静脉内平滑肌瘤病（IVL）是一种罕见的肿瘤，人们对该肿瘤的特点和预后的认识主要来自于孤立的病例报告，缺乏全面的研究。在这项研究中，我们回顾了我们机构 20 年来的 IVL 经验，并开发了一个可用于指导手术管理的分类系统。该研究采用回顾性队列设计，纳入了在我们机构 20 年间接受 IVL 切除术的患者。 2002 年 1 月和 2022 年 12 月。然后在我们提出的分类的 4 个阶段中收集围手术期参数。分析了长期结局、肿瘤学预后以及与复发相关的因素。总共纳入 216 名患者（1 期，n=92；2 期，n=39；3 期，n=76；4 期，n=76）。 =9）。平均随访时间为26.34个月，其中完全切除组中有18例患者（9.7%）出现复发，不完全切除组中有12例患者（39.0%）出现疾病进展。残留疾病的复发或进展与辅助芳香酶抑制剂治疗和最大肿瘤血栓直径相关，但与全子宫切除术和双侧输卵管卵巢切除术、年龄或促性腺激素释放激素激动剂治疗术后治疗无关。这是最大的单中心迄今为止发布的 IVL 报告，提供了有关其临床特征、长期结果以及手术技术的宝贵信息。我们的分类系统可用于评估病变累及的程度并指导手术治疗。版权所有 © 2024。由 Elsevier Inc. 出版。

Intravenous leiomyomatosis (IVL) is a rare neoplasm, the accumulated knowledge about the characteristics and prognosis of this tumor has been derived mainly from isolated case reports with no comprehensive research. In this study, we reviewed our institution's experience with IVL over a 20-year period and developed a classification system that can be used to guide surgical management.The study had a retrospective cohort design and included patients who underwent resection of IVL at our institution between January 2002 and December 2022. Perioperative parameters were then collected among 4 stages of our proposed classification. The long-term outcomes, oncologic prognosis, and factors associated with recurrence were analyzed.A total of 216 patients were included (stage 1, n=92; stage 2, n=39; stage 3, n=76; stage 4, n=9). The mean follow-up duration was 26.34 months, during which 18 patients (9.7%) in the complete resection group had recurrence, and 12 (39.0%) in the incomplete resection group showed disease progression. Recurrence or progression of residual disease was associated with adjuvant aromatase inhibitor therapy and maximum tumor thrombus diameter but not with total hysterectomy and bilateral salpingo-oophorectomy, age, or postoperative treatment with a gonadotropin-releasing hormone agonist therapy.This is the largest single-center report on IVL published to date and provides valuable information on its clinical features and long-term outcomes as well as surgical technique. Our classification system can be used to evaluate the extent of lesion involvement and guide surgical management.Copyright © 2024. Published by Elsevier Inc.