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

Durnalı, Ayşe; Tokluoğlu, Saadet; Özdemir, Nuriye; İnanç, Mevlüde; Alkış, Necati; Zengi̇n, Nurullah; Sönmez, Özlem; Küçüköner, Mehmet; Oncology, Anatolian Society of Medical Oncology Anatolian Society of Medical

doi:10.7314/apjcp.2012.13.5.1935

Cited by 24 publications

(31 citation statements)

References 36 publications

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“…Our data were consistent with Benito et al study which found CS in 48% and LMS in 22% (Benito et al, 2009). Contrast with other studies in Thailand, most common type are LMS .Other previous studies reported different findings, with similar frequency of CS and LMS (Kelly and Craighead, 2005;Koivisto et al, 2008;Park et al, 2008;Durnali et al, 2012). The small number of cases in each study might have exaggerated the different proportion of each uterine sarcoma type.…”

Section: Discussioncontrasting

confidence: 50%

“…Regarding stage of disease, nearly 60% of our patients had early stage. This was comparatively low compared to other studies which reported 60%-76% ( Koivisto et al, 2008;Park et al, 2008;Benito et al, 2009;Durnali et al, 2012). The differences might lie on the extent of operative procedure especially lymph node surgical evaluation and the proportion of the type of sarcoma.…”

Section: Discussioncontrasting

confidence: 44%

“…The small number of cases in each study might have exaggerated the different proportion of each uterine sarcoma type. Nevertheless, our study and all other previous studies found ESS or AS as the least common constituting only 10-30% (Kelly and Craighead, 2005;Koivisto et al, 2008;Park et al, 2008;Benito et al, 2009;Durnali et al, 2012). Our patients' mean age of 54 years was within the range of 50 to 62 years reported in other studies (Livi et al, 2003;Park et al, 2008).…”

Section: Discussionmentioning

confidence: 49%

“…Their prognoses remained unchanged: overall 5-year survival ranged from 18% to 55% (Kelly and Craighead, 2005;Koivisto et al, 2008;Park et al, 2008;Durnali et al, 2012). Being rare tumors, large prospective studies or randomized controlled trials of uterine sarcoma are 1760 not common.…”

Section: Uterine Sarcoma: Clinical Presentation Treatment and Survivmentioning

confidence: 99%

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Uterine Sarcoma: Clinical Presentation, Treatment and Survival Outcomes in Thailand

Potikul¹,

Tangjitgamol²,

Khunnarong³

et al. 2016

Asian Pacific Journal of Cancer Prevention

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Background: Uterine sarcoma is a group of rare gynecologic tumors with various natures, and different lines of treatment. Most have a poor treatment outcome. This study targeted clinical characteristics, treatment, overall survival (OS), progression-free survival (PFS), and prognostic factors in uterine sarcoma patients in one tertiary center for cancer care. Materials and Methods: Uterine sarcoma patients who were treated at the Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital between January 1994 and December 2014 were identified. Clinico-pathological data were analyzed. Prognostic outcomes were examined by Kaplan-Meier curves and Cox regression analysis. Results: We identified 46 uterine sarcoma patients: 25 carcinosarcoma (CS) (54.3%), 15 leiomyosarcoma (LMS) (32.6%), and 6 undifferentiated uterine sarcoma (UUS) (13.1%) cases. Mean age was 54.0±11.9 years (range 25-82 years). Abnormal uterine bleeding was the most common presenting symptom (63.0%). Among 33 patients (71.7%) who had pre-operative tissue collected, diagnosis of malignancy was correct in 29 (87.9%). All patients received primary surgery and retroperitoneal lymph nodes were resected in 34 (73.9%). After surgery, 5 (10.9%) had gross residual tumors. Stage I disease was most commonly found (56.5%). Adjuvant treatment was given to 27 (58.7%), most commonly chemotherapy. After a median follow-up of 16.0 months (range 0.8-187.4 months), recurrence was encountered in 22 patients (47.8%). Median time to recurrence was 5.8 months (range1.0-105.5 months). Distant metastasis was more common than local or locoregional failure. The 2-year PFS was 45.2% (95% confidence interval [CI], 30.6%-59.7%) and the 2-year OS was 48.3% (95% CI, 33.3%-60.7%). Multivariable analyses found residual disease after surgery as a significant factor only for PFS. Conclusions: Uterine sarcoma is a rare tumor entity. Even with multimodalities of treatment, the prognosis is still poor. Successful cytoreductive surgery is a key factor for a good survival outcome.Keywords: Uterine sarcoma -clinical characteristics -survival -prognostic factors -Thailand RESEARCH ARTICLE Uterine Sarcoma: Clinical Presentation, Treatment and Survival Outcomes in ThailandChalermrat Potikul, Siriwan Tangjitgamol*, Jakkapan Khunnarong, Sunamchok Srijaipracharoen, Thaovalai Thavaramara, Kamol Pataradool the mainstay of treatment (Prat, 2009). Slightly different from its carcinoma counterpart, ovarian preservation and exemption of lymph node resection are sometimes acceptable particular in younger age patients and in those with certain types of sarcoma (Leitao et al., 2003;Kapp et al., 2008). Adjuvant therapy after surgery has evolved over the years without a clear benefit on survival (Cearbhail and Hensley, 2010;Rauh-Hain and Carmen, 2013;Cantrell et al., 2015).Despite being derived from various cellular origins and having different pathologic features, most sarcomas have aggressive behavior, high rates of recurrence and poor prognosis even when diagnosed at an early st...

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Section: Discussioncontrasting

confidence: 50%

Section: Discussioncontrasting

confidence: 44%

Section: Discussionmentioning

confidence: 49%

Section: Uterine Sarcoma: Clinical Presentation Treatment and Survivmentioning

confidence: 99%

See 2 more Smart Citations

Uterine Sarcoma: Clinical Presentation, Treatment and Survival Outcomes in Thailand

Potikul¹,

Tangjitgamol²,

Khunnarong³

et al. 2016

Asian Pacific Journal of Cancer Prevention

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“…Adjuvant therapy was chemotherapy in 20 patients, radiotherapy in 9, and sequential chemotherapy plus radiotherapy in 12. They also performed subgroup analyses for the LMS cohort and found that adjuvant sequential chemotherapy plus radiotherapy showed a significantly positive effect on OS (19).…”

Section: Discussionmentioning

confidence: 99%

Impact of adjuvant treatment on oncologic outcomes inpatients with stage I leiomyosarcoma of the uterus

et al. 2017

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Background/aim: This study aimed to evaluate the role of adjuvant therapy for stage I uterine leiomyosarcoma (LMS).Materials and methods: Clinicopathological data of cases of stage I uterine LMS from 1998 to 2015 were retrieved from the computerized database of Hacettepe University Hospital. The Kaplan-Meier method was used to estimate survival and progression-free survival, and survival differences were analyzed by log-rank test. Cox regression analysis was performed to account for the potential influence of confounding factors. Results:We evaluated the outcomes of 35 patients with histologically proven stage I LMS. The median age at diagnosis was 50 years. All patients underwent surgical treatment and 20 patients (57.1%) received adjuvant therapy. Twelve of these patients (34.3%) received adjuvant chemotherapy, 3 (8.6%) received adjuvant pelvic irradiation, and 5 (14.2%) received adjuvant chemotherapy with pelvic irradiation. The median follow-up duration was 34 months (range: 3-231 months). Twenty-three (65.7%) patients had a recurrence during follow-up. Adjuvant therapy did not significantly improve median progression-free survival or median overall survival. Cox regression analysis did not demonstrate any significant impact of the factors studied, including age, menopausal status, tumor size, mitotic count, staging surgery, or adjuvant therapy. Conclusion:Adjuvant therapy for surgically treated stage I uterine LMS did not improve oncologic outcomes.

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S2k-Leitlinie Diagnostik und Therapie uteriner Sarkome – Anforderungen an die Pathologie

Horn

Höhn

Denschlag³

et al. 2020

Pathologe

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

Cited by 24 publications

References 36 publications

Uterine Sarcoma: Clinical Presentation, Treatment and Survival Outcomes in Thailand

Uterine Sarcoma: Clinical Presentation, Treatment and Survival Outcomes in Thailand

Impact of adjuvant treatment on oncologic outcomes inpatients with stage I leiomyosarcoma of the uterus

S2k-Leitlinie Diagnostik und Therapie uteriner Sarkome – Anforderungen an die Pathologie

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