Uterine Sarcomas: 15-year Experience from a Tertiary Care Cancer Hospital in India

Abstract

Introduction: Uterine sarcomas are rare neoplasms with poor prognosis comprising around 2-6% of uterine malignancies. They include leiomyosarcomas, endometrial stromal sarcomas, undifferentiated sarcomas, carcinosarcomas (previously existed, but it does not exist anymore) and few other rare variants. Leiomyosarcomas are the most common uterine sarcoma. The most common clinical presentation is postmenopausal vaginal bleeding while others include lower abdominal pain and white discharge per vaginum. This study analyzes the general patient characteristics and survival data of uterine sarcoma patients treated in our institute. Materials and methods:The patients treated for uterine sarcomas in our institute from 2004 to 2019 were identified and their case records analyzed. The patient's baseline characteristics, stage distribution, recurrence patterns, survival, outcomes of laparoscopic, and open approaches in treating uterine sarcomas are all analyzed. Results: Totally, 31 patients were treated during the time period out of which 6 patients were lost the follow-up. The mean age of patients at diagnosis was 46.5 years. The most common type in our center was endometrial stromal sarcoma. Eleven (35%) patients had recurrence. Those with recurrences were offered surgery when it was limited to pelvis. The adjuvant chemotherapy and radiation were given as indicated. Four patients had a history of tamoxifen intake. Eight patients (25%) had died during the follow-up which makes up to 72% of the recurred patients. The median disease-free survival was 45 months after a median follow-up of 90 months. Conclusion: Although uterine sarcomas have poor prognosis, our patients had better prognosis on comparison with literature. The stage of the disease and the pathological type are the important factors determining prognosis. Laparoscopy offers better postoperative outcomes and larger studies are needed to demonstrate their oncological safety.