Clinical outcomes of uterine sarcomas: results from 14 years worth of experience in the Kinki district in Japan (1990-2003)

Abstract

To review clinical outcomes and therapeutic varieties, we were invited to submit data from the patients who were treated for uterine sarcomas in Japan from 1990 to 2003. Uterine sarcomas were defined as leiomyosarcoma (LMS), endometrial stromal sarcoma (ESS), and carcinosarcoma (CS). Of a total of 97 patients, 36 (37.1%) were diagnosed with LMS of the uterine corpus, 15 (15.5%) with ESS, 46 (47.4%) with CS. Median age at diagnosis was 59 (21-85) years. Clinical stages based on FIGO were 41 (42.3%) with stage I disease, 6 (6.2%) with staged II, 34 (35.1%) with stage III, and 16 (16.5%) with stage IV. The median follow-up period for all patients was 13 (1-108) months and median disease-free period was 9 (0-96) months. The 1-year survival rate and disease-free survival (DFS) rate were calculated in patients with all sarcomas (overall survival [OAS], 61.3%; DFS, 46.6%). Statistical analysis showed that younger age (less than 50 years), early stage (stages I and II), and surgical procedure (extended hysterectomy [EH] and radical hysterectomy [RH]) were associated with significantly better OAS. Histologic types did not affect the survival period. In conclusion, aggressive surgery including EH or RH at the time of initial operation offers the possibility of prolonged survival.

Prognostic Factors and Treatment Outcomes in 93 Patients with Uterine Sarcoma from 4 Centers in Turkey

“…As reported in other studies (Chavenic et al,1999;El Husseiny et al, 2002;Kokawa et al, 2006;KoivistoKorander et al, 2008;Tsikouras et al, 2008), in our study most patients were diagnosed at early stages (stage I-II, 63.4%). Most of the patients in LMS group and ESS group were diagnosed at stage I-II (74.1% and 88.9% respectively), while MMMT group was mainly diagnosed at advanced stages (stage III-IV, 64%).…”

“…There is no consensus on prognostic factors of uterine sarcomas. Several studies have found no effecet of age on survival (Peters et al,1984;El Husseiny et al, 2002;Park et al, 2008), whereas some studies reported that patients younger than age 50 years had longer survival (Nagell et al, 1986;Kokawa et al, 2006). In our study patients younger than age 60 years had significantly longer RFS and OS.…”

Prognostic Value of the Diagnostic Criteria Distinguishing Endometrial Stromal Sarcoma, Low Grade From Undifferentiated Endometrial Sarcoma, 2 Entities Within the Invasive Endometrial Stromal Neoplasia Family

“…The problem with regard to earlier studies is that the various conditions were aggregated, preventing meaningful analysis of any single variable (6)(7)(8)(9)(10)(11)(12)(13). Further, some recent studies are still using the older classification (14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27) …”

Malignant Tumors of the Female Reproductive System

“…Depending on the histological classification used, uterine sarcomas represent about 3 to 9% of cancers of the corpus uteri and 1% of all cancers of the female reproductive system [19,21]. The prognosis for certain histological types, such as uterine sarcoma, is quite poor; overall 5-year survival ranges from 17 to 53% [21][22][23]. For endometrial stromal sarcoma, the www.e-shaw.org prognosis is better than for other uterine sarcomas.…”