Objective: To determine the preoperative clinical characteristics associated with uterine sarcoma in patients with uterine mass. Methods: We retrospectively reviewed medical records of patients who presented with uterine mass undergoing surgery at Ramathibodi Hospital, with a pathologically confirmed diagnosis, from April 1, 2000 to October 31, 2019. The cases were patients with uterine sarcoma, whereas the controls were patients with leiomyoma diagnosed in the same year, with a proportion of 1 case per 4 controls. The association between preoperative clinical characteristics and uterine sarcoma were analyzed. Results: There were 18,218 patients with uterine mass undergoing surgery at Ramathibodi Hospital during the study period. Uterine sarcoma was diagnosed in 68 patients. Thus, the incidence of uterine sarcoma was 0.37%. Patients with uterine mass, patients with age >40 years old, postmenopause, postmenopausal bleeding, abnormal uterine bleeding, palpable mass, recognition of rapid growing mass, and with single tumor nodule identified by ultrasonography were more likely to be diagnosed with uterine sarcoma with adjusted odds ratio (95%
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