Prognostic factors associated with uterine sarcomas: the experience of a single institution

Barquet-Muñoz, Salim Abraham; Isla‐Ortiz, David; Montalvo-Esquivel, Gonzalo; Cantú-de-León, David; Salcedo‐Hernández, Rosa A.; Cordoba-Gonzalez, Veronica; Herrera‐Gómez, Ángel

doi:10.1080/01443615.2018.1492529

Cited by 7 publications

(12 citation statements)

References 15 publications

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“…Excluding CS from the classification, LMS was the most frequent subtype of uterine sarcoma, constituting 57.9% of cases. These data agree with the results reported by other authors, i.e., between 40-60% of uterine sarcomas [1,2,[4][5][6]8,[16][17][18][19]22].…”

Section: Observational Studysupporting

confidence: 93%

“…The survival analysis indicated that postmenopausal status, higher FIGO stage (III-IV), and the presence of residual tumours after surgery were significantly associated with a poorer mean survival, in agreement with other studies [2,8,11,18,19,25]. However, no statistically significant differences were observed with respect to OS or with respect to DFS among the different histological subtypes.…”

Section: Observational Studysupporting

confidence: 89%

“…Regarding stage at diagnosis, the differences found among the subgroups trended towards statistical significance (p = 0.05). A total of 62.3% were diagnosed at early stages; similar data have been reported in the literature, ranging from 56.4 to 69% [3,4,8,[11][12][13]18].…”

Section: Observational Studysupporting

confidence: 76%

“…The initial selection identified a total of 7330 that did not meet the inclusion criteria after applying filters. Of a total of 195 studies that were retrieved to evaluate eligibility, 18 were selected as relevant [1,[3][4][5][6][8][9][10][11][12][13][15][16][17][18][19][20][21]. Figure 3 shows a flow chart that illustrates the selection of studies.…”

Section: Systematic Reviewmentioning

confidence: 99%

“…In our study, we had a recurrence rate of 45.3%, with no statistically significant differences among the different subtypes. These tumours have a high recurrence rate; some studies report a recurrence rate of 50-70% [4,12,18]; others, such as those by Benito et al [12] and Sait et al [9], observed recurrence rates lower than 35% and 22%, respectively. This is also reflected in a DFS rate of less than 50%.…”

Section: Observational Studymentioning

confidence: 99%

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Retrospective Analysis of Patients with Gynaecological Uterine Sarcomas in a Tertiary Hospital

Ruiz-Minaya

Mendizabal-Vicente

Vásquez-Jiménez

et al. 2022

JPM

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Uterine sarcomas are rare and heterogeneous malignancies accounting for 1% to 3% of all gynaecological tumours. There are many histological subtypes recognised, including leiomyosarcomas, endometrial stromal sarcoma, and uterine carcinosarcoma, although the latest has been recently discarded in this group. Despite its low incidence, these types of cancer currently entail multiple challenges, either in diagnostics or clinical management, with a poor prognosis associated. The present work aimed to complete a comparative analysis of the different histological subtypes based on the clinicopathological characteristics of our population, the therapeutic characteristics, and associated prognosis in 161 patients treated in our centre during the period between 1985 and 2020. Moreover, a systematic review grouped a total of 2211 patients with a diagnosis of uterine sarcoma from 19 articles published in 16 countries from 2002 to 2021 was performed, all with retrospective analyses. Our results showed that apart from uterine carcinosarcoma, leiomyosarcoma is the most frequent subtype of uterine sarcoma, with unique clinical, demographic, and survival parameters. To our knowledge, this is the first systematic review conducted in this field and, thus, it shows the difficulties of collecting a significant number of patients per year, a valid reason why multicentre or national registries are recommended to allow a more exhaustive analysis of this pathology.

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Section: Observational Studysupporting

confidence: 93%

Section: Observational Studysupporting

confidence: 89%

Section: Observational Studysupporting

confidence: 76%

Section: Systematic Reviewmentioning

confidence: 99%

Section: Observational Studymentioning

confidence: 99%

See 3 more Smart Citations

Retrospective Analysis of Patients with Gynaecological Uterine Sarcomas in a Tertiary Hospital

Ruiz-Minaya

Mendizabal-Vicente

Vásquez-Jiménez

et al. 2022

JPM

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Clinical characteristics and prognosis analysis of uterine sarcoma: a single-institution retrospective study

et al. 2022

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Background Uterine sarcomas are rare and aggressive gynaecologic malignancies, characterized by a relatively high recurrence rate and poor prognosis. The aim of this study was to investigate the clinicopathological features and explore the prognostic factors of these malignancies. Methods This was a single-institution, retrospective study. We reviewed the medical records of 155 patients with pathologically confirmed uterine sarcomas including uterine leiomyosarcoma (ULMS), low-grade endometrial stromal sarcoma (LG-ESS), high-grade endometrial stromal sarcoma (HG-ESS), undifferentiated uterine sarcoma (UUS) and adenosarcoma (AS) between 2006 and 2022. A total of 112 patients who underwent surgery between January 2006 and April 2019 were included in the survival analysis. The current study recorded the clinicopathological, treatment and outcome data to determine clinical characteristics and survival. Results The most common histopathological type was ULMS (63/155, 40.64%), followed by LG-ESS (56/155, 36.13%) and HG-ESS (16/155, 10.32%). The mean age at diagnosis of all patients was 49.27±48.50 years and 32.90% (51/155) of patients were postmenopausal. Fifteen patients underwent fast-frozen sectioning, 63(54.78%) were diagnosed with malignancy, 29(25.22%) were highly suspected of malignancy that needed further clarification and 23(14.84%) were diagnosed with benign disease. A total of 124(80%) patients underwent total hysterectomy (TH) and salpingo-oophorectomy. Multivariate analyses showed that histological type and tumour size were independent prognostic factors both for overall survival (OS) (p<0.001 and P=0.017, respectively) and progression-free survival (PFS) (p<0.001 and P=0.018, respectively). Tumour stage was only significantly associated with PFS (P=0.002). Elevated preoperative NLR, PLR and postmenopausal status were significantly correlated with shorter PFS and OS in univariate analysis, but no statistically significant difference was found in multivariate analysis. Conclusions In patients with uterine sarcoma, in comparison to LMS and LG-ESS, UUS and HG-ESS tend to present as more aggressive tumour with poorer outcomes. Furthermore, larger tumour (>7.5 cm) were an important predictor of shorter PFS and OS.

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Clinical features of uterine sarcomas presenting mainly with uterine masses: a retrospective study

Zhu¹,

Chen²

2023

BMC Women's Health

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Background Uterine sarcomas are uncommon mesenchymal tumors of the uterus. The clinical problem is that the features of uterine sarcomas can sometimes mimic uterine fibroids. This study aims to investigate the clinical characteristics of patients with uterine sarcomas who were preoperative presenting mainly with uterine masses. Methods A retrospective analysis of patients who underwent gynecological surgery for uterine sarcomas at the Obstetrics & Gynecology Hospital of Fudan University, between January 2016 and December 2021. Results Over the 5-year period, 277 patients were final diagnosed of uterine sarcomas. A total of 162 patients were preoperatively diagnosed as uterine fibroids for surgical treatment, the majority of whom were diagnosed of uterine leiomyosarcoma (uLMS) (49/162) and low-grade endometrial stromal sarcoma (LG-ESS) (100/162). Ninety people underwent total hysterectomy and bilateral salpingo-oophorectomy (TH + BSO), while 72 underwent myomectomy followed by supplemental TH + BSO. The group with direct hysterectomy had a higher average age than the group with prior myomectomy (47.20 ± 8.94 vs. 40.86 ± 5.88, p < 0.001). Among patients preoperatively diagnosed as uterine fibroids, patients with uLMS had a higher proportion of previous myomectomy (26.53% vs. 5.00%, p < 0.001), a larger uterine mass diameter on ultrasound (8.38 ± 3.39 cm vs. 6.41 ± 1.92 cm, p < 0.001), and richer hypervascularity (34.69% vs. 18%, p = 0.024) compared with LG-ESS. Conclusions Analysis of our data showed that a large proportion of uterine sarcomas, especially uLMS and LG-ESS, present mainly with uterine masses. Ultrasound features including a large uterine mass diameter and rich hypervascularity, and with a history of myomectomy may alert clinicians in suspicion of uLMS when compared with LG-ESS.

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Prognostic factors associated with uterine sarcomas: the experience of a single institution

Cited by 7 publications

References 15 publications

Retrospective Analysis of Patients with Gynaecological Uterine Sarcomas in a Tertiary Hospital

Retrospective Analysis of Patients with Gynaecological Uterine Sarcomas in a Tertiary Hospital

Clinical characteristics and prognosis analysis of uterine sarcoma: a single-institution retrospective study

Clinical features of uterine sarcomas presenting mainly with uterine masses: a retrospective study

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