Prognostic Factors and Treatment Modalities in Uterine Sarcoma

Abstract

The aim of this study was to identify the impact of various prognostic factors in the management of uterine sarcoma. Fifty-nine patients with uterine sarcoma were treated at King Faisal Specialist Hospital and Research Center between 1980 and 1997. Forty-three patients (73%) were treated by total abdominal hysterectomy and bilateral salpingo-oophorectomy, 7 (12%) total abdominal hysterectomy and bilateral salpingo-oophorectomy with sampling of pelvic lymph nodes, and 9 (15%) had biopsy only. Nine patients received adjuvant treatment; five had radiation therapy (XRT), two had chemotherapy, one had combined XRT and chemotherapy, and one received hormonal treatment. Leiomyosarcoma cases accounted for 42% of all the uterine sarcomas, carcinosarcoma cases for 34%, and endometrial stromal sarcoma (ESS) for 24%. Fifty (85%) patients had pathologic grade II and III tumor, with only 9 patients grade I. Twenty-seven patients (46%) were classified surgically as stage I, 7 (12%) as stage II, 17 (29%) as stage III, and 8 (13%) had stage IV tumor. Recurrences developed in 34 patients (71%). The 5- and 10-year overall actuarial survival for all patients was 42%, and the corresponding relapse-free survivals for those who achieved complete response after primary treatment (48 patients) were 27% and 20%. On the univariate analysis, grade I tumors (p = 0.04), ESS (p = 0.02), nonmetastatic stage (p = 0.05), and negative peritoneal cytology (p = 0.04) were associated with better overall survival. Factors associated

Prognostic factors and treatment outcomes of patients with uterine sarcoma: analysis of 127 patients at a single institution, 1989–2007

“…This is consistent with previous the reports of DFS rates, ranging from 34 to 36% (Chauveinc et al 1999;El Husseiny et al 2002). The overall OS rate for patients in our study was 48%, which coincides with previous reports in the range of 45-47% (Nordal and Thoresen 1997;Chauveinc et al 1999;Denschlag et al 2007).…”

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%).…”

“…In our study and also in literature, uterine sarcomas have poor prognosis, 5-year OS in previous studies was ranging between 27-51% (Schwartz & Thomas, 1989;Chavenic et al, 1999;Pautier et al, 2000;El Husseiny et al, 2002;Livi et al, 2003;Benoit et al,2005;KoivistoKorander et al, 2008;Tsikouras et al, 2008). 5-year OS in our study was 49.4%.…”

“…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.…”

“…Recurrence rates for uterine sarcomas have been reported as 50%-71% (Tsikouras et al, 2008;KoivistoKorander et al, 2008;El Husseiny et al, 2002;Benoit et al, 2005), recurrence rate in our study was 63.4% and median time to recurrence was less than 2 years (11 months) as reported in a review (Gaducci et al, 2008). In previous studies, recurrence sites of relapsed patients were pelvic recurrence (14-30%); distant recurrences (33-44%), pelvic and distant recurrences (25-53%) (Gaducci et al, 2008).…”