title: [Uterine sarcomas: clinical and therapeutic aspects (10 cases)].
abstract: OBJECTIVE
  Uterine sarcomas are rare tumours characterized by clinical and histopathological diversity and poor prognosis. We analyzed diagnostic, prognostic and therapeutic difficulties encountered with these tumors by insisting on the importance of early diagnosis.
  
  
  METHODS
  From 1997 to 2004 ten patients with uterine sarcoma who underwent surgery in the obstetrics and gynecology unit at the Tunis maternity center were included in this retrospective study. The tumors were classified at the time of diagnosis using the FIGO staging system. The histological diagnosis was based on the WHO classification.
  
  
  RESULTS
  There were 5 cases of leiomyosarcoma, 2 cases of carcinosarcoma, 2 cases of endometrial stromal sarcoma and 1 adenosarcoma. There were four cases of stage I, two cases of stage II, two cases of stage III and two of stage IV tumors. The diagnosis of uterine sarcoma was strongly suspected and proved before the initial operation in 20% of cases and during this operation in 60% of cases. Diagnosis was only established at the histological exam in two cases. Total hysterectomy with bilateral salpingo-oophorectomy was performed in 90% of patients. Radiation therapy was performed in four. Chemotherapy was delivered in two patients. After an average of four years five patients were in remission, three had died and two were lost to follow-up.
  
  
  CONCLUSIONS
  Early preoperative or intra-operative diagnosis is essential while awaiting for more effective chemotherapy protocols or therapeutic strategies.
authors.affiliation: Service A de Gynécologie Obstétrique, Centre de Maternité et de Néonatologie de Tunis, Tunisie.
authors.forename: A
authors.initials: A
authors.lastname: Hassini
authors.forename: B
authors.initials: B
authors.lastname: Khemiri
authors.forename: E
authors.initials: E
authors.lastname: Sfar
authors.forename: D
authors.initials: D
authors.lastname: Chelly
authors.forename: M B
authors.initials: MB
authors.lastname: Chennoufi
authors.forename: H
authors.initials: H
authors.lastname: Chelly
mesh_terms: D000293:Adolescent; D000328:Adult; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D009367:Neoplasm Staging; D010052:Ovariectomy; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012509:Sarcoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery* / Q000628:therapy