Outcome analysis in patients with uterine sarcoma

Abstract

PurposeTo analyze the prognostic factors for survivals and to evaluate the impact of postoperative whole pelvic radiotherapy (WPRT) on pelvic failure in patients with uterine sarcoma treated with radical surgery.Materials and MethodsWe retrospectively analyzed 75 patients with uterine sarcoma who underwent radical surgery with (n = 22) or without (n = 53) radiotherapy between 1990 and 2010. There were 23 and 52 patients with carcinosarcoma and non-carcinosarcoma (leiomyosarcoma, 22; endometrial stromal sarcoma, 25; others, 5), respectively. The median follow-up period was 64 months (range, 17 to 269 months).ResultsThe 5-year overall survival (OS) and pelvic failure-free survival (PFFS) of total patients was 64.2% and 83.4%, respectively. Multivariate analysis revealed that mitotic count (p = 0.006) was a significant predictor of OS. However, factors were not found to be associated with PFFS. On analyzing each of the histologic subtypes separately, postoperative WPRT significantly reduced pelvic failure in patients with carcinosarcoma (10.0% vs. 53.7%; p = 0.046), but not in patients with non-carcinosarcoma (12.5% vs. 9.9%; p = 0.866). Among the patients with carcinosarcoma, 4 patients (17%) had recurrence within the pelvis and 3 patients (13%) had recurrence in other sites as an initial failure, whereas among the patients with non-carcinosarcoma, 3 patients (6%) experienced pelvic failure and 13 patients (25%) experienced distant failure.ConclusionThe most significant predictor of OS was mitotic count. Based on the improved PFFS after postoperative WPRT only in patients with carcinosarcoma and the difference in patterns of failure between histologic subtypes, optimal adjuvant treatment options should be offered to patients based on the risk of recurrence patterns.

Distribution and survival of primary sarcoma in Korea: A single center analysis of 2017 cases

“…Leiomyosarcoma demonstrated 65.2% in 5-year OS in present study, which is similar with other reports (64.2%-65.7%) [20,21]. In subgroup analysis between uterus group (72.2%) with non-uterus group (62.4%) in leiomyosarcoma, demonstrated favor survivorship in uterus group than non-uterus group without statistical significance in present study.…”

Preoperative Neutrophil-to-Lymphocyte Ratio as a Prognostic Factor in Uterine Sarcoma

“…Several prognostic factors have been recognized from retrospective data to guide therapeutic decisions for uterine sarcoma patients. Patients with old age, advanced stage, high tumor grade, and high mitotic index have been found to have worse prognosis [ 13 , 14 , 15 , 16 ]. However, diagnosis and treatment of uterine sarcoma remain unclear.…”

Clinical significance of radiotherapy in patients with primary uterine carcinosarcoma: a multicenter retrospective study (KROG 13-08)

“…Adjuvant radiotherapy (RT), as a component of disease management, is known to improve locoregional control in patients with UCS, although its impact on survival remains controversial [6789]. The limited availability of information regarding surgical staging and prognostic factors makes it difficult to draw conclusions from the current literature [7].…”