Preoperative diagnosis and treatment results in 106 patients with uterine sarcoma in Hokkaido, Japan.
OBJECTIVE
The aim of this study was to evaluate the clinicopathological features of uterine sarcoma in Hokkaido, Japan, between 1990 and 1999, and to identify prognostic factors of patients with such malignancies in this area and period.


METHODS
One hundred and six patients with histologically proven uterine sarcoma were evaluated retrospectively.


RESULTS
93.5% of the patients with carcinosarcoma (CS) were diagnosed as having malignant disease preoperatively, while 65% of those with leiomyosarcoma (LMS) and 75% of those with endometrial stromal sarcoma (ESS) were preoperatively diagnosed as benign leiomyoma. When patients had no residual disease postoperatively, 5-year survival rates in patients with CS and LMS were 78.8 and 73.0%, respectively. ESS cases had a better prognosis (94.7% for stage I cases). In patients with early-stage sarcoma, pelvic lymphadenectomy and adjuvant chemotherapy, with or without cis-diamminedichloroplatinum, failed to show a survival benefit in both CS and LMS cases. Distant metastasis, myometrial invasion, and no residual disease at surgery were significantly associated with risk of death or recurrence in CS and LMS cases.


CONCLUSIONS
Accurate preoperative diagnosis of uterine sarcoma was difficult, and no residual disease at surgery was the most important prognostic factor in patients with this disease. Postoperative adjuvant therapy had little effect on survival, especially in early-stage disease.
Department of Obstetrics and Gynecology, Sapporo Medical University, School of Medicine, Chuou-ku, Japan. sagaes@sapmed.ac.jp
Satoru
S
Sagae
Kohki
K
Yamashita
Shinichi
S
Ishioka
Yoshihiro
Y
Nishioka
Katsuhiko
K
Terasawa
Mitsuru
M
Mori
Katsushige
K
Yamashiro
Toshitaka
T
Kanemoto
Ryuichi
R
Kudo
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002296:Carcinosarcoma / Q000175:diagnosis / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000627:therapeutic use; D003937:Diagnosis, Differential; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007564:Japan; D007890:Leiomyosarcoma / Q000175:diagnosis / Q000601:surgery; D008197:Lymph Node Excision; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012509:Sarcoma / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery*; D016019:Survival Analysis; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery*
D002945:Cisplatin