Uterine Sarcomas: Experience from a Tertiary Cancer Care Center from India

Nusrath, Syed; Bafna, Sandeep; Raman, Rajagopalan; Thammineedi, Subramanyeshwar Rao; Raju, K. V. V. N.; Patnaik, Sujit Chyau; Pawar, Sagar; Reddy, Yugandhar P.; Chavali, Ramachandra Nagaraju; Murthy, Sudha

doi:10.1007/s13193-018-0860-5

Cited by 6 publications

(5 citation statements)

References 26 publications

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“…However, it has been reported that additional therapeutic interventions may yield controversial results (20,24). In the present study, only 1 out of 21 patients treated primarily with radiotherapy and/or chemotherapy without surgery, exhibited a satisfactory clinical response, highlighting the poor response of these cases to the standard radiotherapy treatment, which has been previously shown (14,21,25). An additional factor, which was indicative of the aggressiveness of sarcomas and possibly of the delay for diagnosis and management, was the lack of treatment noted in the six untreated cases, which was due to the advanced stage of the disease.…”

Section: Discussionsupporting

confidence: 60%

Diagnosis, treatment and survival of uterine sarcoma: A retrospective cohort study of 122 cases

et al. 2020

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The present study aimed to assess the diagnosis, treatment and follow-up of uterine sarcoma cases. A retrospective cohort study with 122 women recruited between 2001 and 2016 was performed. The data regarding epidemiology, clinical presentation, treatment and follow-up were analyzed based on the following histological types: Carcinosarcoma, leiomyosarcoma, endometrial stromal sarcoma (ESS) and adenosarcoma. Statistical analysis included descriptive statistics, logistic regression and survival curves. The diagnosis of uterine sarcoma exhibited an increasing trend of +1.2 new cases every 2 years (P=0.044) and comprised 10% of all uterine cancer diagnoses. There were 47% carcinosarcomas, 22% leiomyosarcomas, 16% ESS and 14% adenosarcomas. The majority of the women was ≥60 years old (62%). Among the subjects, 77% were postmenopausal, 61% had a body mass index up to 29.9 kg/m 2 and 71% presented with a comorbidity. Regression analysis exhibited an association between post menopause and the histological type associated with lower overall survival (OS), namely leiomyosarcoma or carcinosarcoma (odds ratio, 5.45, P<0.001). Stage I malignancy was present in 44% and Stage IV in 22%. The treatment included primary surgery in 78% of the cases, whereas 79% received adjuvant therapy. Only 55 cases achieved disease control and 20 relapsed (36%) with a 5-year OS rate of 33%. The OS was lower for carcinosarcoma and leiomyosarcoma (20%; P=0.003). In summary, the present study indicated that the number of uterine sarcoma cases had increased between 2001 and 2016. The majority of the women were >60 years old and diagnosed in advanced stages. The postmenopausal status was associated with histological types of poor prognosis. The OS was low and worse for patients with carcinosarcoma and leiomyosarcoma.

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Section: Discussionsupporting

confidence: 60%

Diagnosis, treatment and survival of uterine sarcoma: A retrospective cohort study of 122 cases

et al. 2020

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“…A case series of 11 patients with the diagnosis of uterine sarcoma reported a median survival of 6.5, 18, and 56 months for LMS, ESS, and AS, respectively, with a 5-years OS of only 20%. 12 Similar outcomes were reported in a retrospective study on 61 patients with a median OS of 31.07 months, but their cohort included patients with Ewings sarcoma and rhabdomyosarcoma in addition to LMS, HGESS, and UES. 13 Longest survival was reported for ESS and shortest for carcinosarcoma in a retrospective study on 42 patients.…”

Section: Discussionmentioning

confidence: 56%

Clinicopathological Profile, Surgical Practices and Outcomes of the Patients with Uterine Sarcoma: A Single Institutional Study from Eastern India

Mahapatra¹,

Nayak²,

Parija³

et al. 2022

Journal of South Asian Federation of Obstetrics and Gynaecology

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Aim:The study aimed to analyze the clinicopathological profile, surgical practices, and survival outcomes of the patients with uterine sarcoma in eastern India. Background: Uterine sarcomas are a rare entity among gynecological malignancies with a very unfavorable prognosis. Due to its rarity, there is no consensus on a standardized treatment approach. Materials and methods: A retrospective analysis of all patients with a histopathological diagnosis of uterine sarcomas who were treated in our institute from 2012 to 2016 was done. The clinical parameters, treatment given, histopathological report, stage, and follow-up details of all patients were reviewed. Survival analysis was done using Kaplan-Meier method. Results: From 2012 to 2016, 40 patients with a diagnosis of uterine sarcoma were recorded. The median age of the patients was 44 years (range, 18-68 years). The youngest patient who got treated was an 18-year-old with low-grade endometrial stromal sarcoma (LGESS) with stage IIIC disease. Majority of the patients presented with abnormal uterine bleeding (60%) followed by abdominal pain (30%). Low-grade endometrial stromal sarcoma (42%) was the most frequent histological subtype of uterine sarcoma encountered followed by leiomyosarcoma (LMS) (40%), adenosarcoma (AS) (7.5%), undifferentiated endometrial sarcoma (UES) (5%), high-grade endometrial stromal sarcoma (HGESS) (2.5%), and uterine smooth muscle tumor of uncertain malignant potential (STUMP) (2.5%). Majority of the patients were diagnosed at stage I (92.5%) and only 2.5% of patients had stage IIIC disease. The patients were followed up for a median duration of 15 (range, 4-180) months. The median survivals of the patients diagnosed with different histological subtypes were 32, 11, 4, 9.5, 26, and 42 months for LGESS, LMS, HGESS, UES, AS, and STUMP, respectively. Median disease-free survival (DFS) for the entire cohort of uterine sarcoma was 32 months, and median overall survival (OS) was 57 months. Conclusion: Uterine sarcoma, when diagnosed even at an early stage was associated with increased recurrence rate and mortality. Clinical significance: Due to its aggressive behavior, an early diagnosis and a multimodal treatment approach should be considered.

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“…Two patients with ESS were stage 1, and 2 patients with ESS were stage 4 and the patient with AS was stage 1 in their study group. Apart from our study there was no patient with USS (19) . Kyriazoglou et al retrospectively analyzed patients treated for uterine sarcomas in their institution over a period of 17 years.…”

Section: Tab 4 the Treatment Modality And Recurrence Pattern Of Patmentioning

confidence: 67%

Uterine sarcomas: 7-year experience from a tertiary center

Yetimalar¹,

Kılıç²,

Yiğit³

2020

Curr Gynecol Oncol

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Uterine sarcomas are rare and aggressive gynecologic malignancies. Due to their rarity, histopathologic heterogeneity and molecular diversity, the optimal approach is still a matter of debate. Debulking surgery is still the mainstay of the treatment. But adjuvant treatment strategies remain controversial. In this study, we aimed to examine the clinical characteristics, histopathological features, tumoral behavior and recurrence patterns of patients diagnosed with uterine sarcoma at a tertiary referring center over a 7-year period. A total of 427 patients who were treated for uterine cancer between 2007 and 2014 were analyzed retrospectively. There were in total 20 patients diagnosed with uterine sarcoma. Median age of all patients diagnosed as uterine sarcomas was 50.5 years [interquartile range 11.5 (43.5-55)]. The median tumor size in these patients was 5.75 cm [interquartile range 4.38 (4.12-8.50)]. There were 5 patients with leiomyosarcomas, 10 patients with endometrial stromal sarcomas, 4 patients with undifferentiated uterine sarcomas and 1 patient with adenosarcoma. Despite our limited data, we presented our retrospective series over a period of 7 years. Prospective data and further insights are needed to better understand the tumor biology and improve treatment modalities.

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Uterine Sarcomas: Experience from a Tertiary Cancer Care Center from India

Cited by 6 publications

References 26 publications

Diagnosis, treatment and survival of uterine sarcoma: A retrospective cohort study of 122 cases

Diagnosis, treatment and survival of uterine sarcoma: A retrospective cohort study of 122 cases

Clinicopathological Profile, Surgical Practices and Outcomes of the Patients with Uterine Sarcoma: A Single Institutional Study from Eastern India

Uterine sarcomas: 7-year experience from a tertiary center

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