[In Process Citation]
OBJECTIVE: The objective of the study was to analyse the prognostic impact of several criteria for median survival and recurrence free interval in patients with uterine sarcomas. Factors included to our analysis were the staging according to FIGO, DNA content (ploidy), mitotic index, histology, the kind of primary therapy, grading and menopausal status. MATERIAL AND METHODS: Retrospectively, clinical data of 78 patients (41 leimyosarcomas, 23 carcinosarcomas = homologous malignant mixed Mullerian tumors, 14 endometrial stromal sarcomas--10 low grade, 4 high grade) were analysed. Additionally, in 36 of the cases mitoses were counted. Furthermore, DNA ploidy was determined using image cytometry on paraffine sections stained according to the Feulgen method. Receptor status was determined using immunohistochemical staining. Two and five year survival rates were 22% and 15%. There were 21 cases with local relapse and 27 cases with metastasis. RESULTS: The staging according to FIGO was the main prognostic factor, significantly influencing median survival time (p = 0.001) as well as the recurrence free interval (p = 0.03). There was a significant difference between median survival time compared to mitotic index (p = 0.014) and DNA ploidy (p = 0.02). A mitotic index < 10/10 HPF and diploidy were related with a better prognosis. Receptor status did not have an impact on median survival time. CONCLUSIONS: As our results suggest, DNA ploidy and mitotic index are likely to provide additional information for prognosis in patients with uterine sarcomas and could be used as criteria for selecting patients for adjuvant therapy.
M
Wolf
J
Schmitt
W
Weise
S
Olbricht
A
Roessner
Uterussarkome--eine retrospektive Analyse von 78 Fallen.