[Postoperative radiotherapy of uterine sarcoma: a multicentric retrospective study].
OBJECTIVE
Surgery is the treatment of choice for localized uterine sarcomas. We conducted a retrospective study to define prognostic factors.


METHODS
We studied 111 cases of patients treated by adjuvant radiotherapy for uterine sarcoma in seven French centers. The median decline was 31 months. We conducted a univariate analysis to identify factors correlated with local recurrence. The statistically significant factors were studied in multivariate analysis by Cox model.


RESULTS
The median dose of external beam radiotherapy was 45 Gy. Forty-three percent of patients had vaginal vault brachytherapy and 21 % chemotherapy. Only 6.3 % of patients had complications of acute grade III and 8.1 % of long-term sequelae of radiotherapy. The survival rate at 5 years was 74.6 %. They noted 12.6 % of isolated locoregional recurrences, against 29.7 % for distant recurrences, 80 % were pulmonary. Factors correlated with the risk of locoregional relapse were menopausal status (P = 0.045) and surgical margins suspicious or not healthy (P = 0.0095). The chemotherapy did not improve overall survival or disease free survival but the numbers were low.


CONCLUSIONS
The postoperative radiotherapy provides good local control in this disease. Brachytherapy is sometimes done, but it does not improve local control. Chemotherapy is not a standard localized stage but the rate of metastatic recurrence calls for the development of strategies involving systemic treatment with radiotherapy.
Champetier
C
C
Service de Radiothérapie, Hôpital de la Timone, 264 Rue Saint-Pierre, 13385 Marseille cedex 05, France. c.champetier@live.fr
Hannoun-Levi
J-M
JM
Resbeut
M
M
Azria
D
D
Salem
N
N
Tessier
E
E
Ellis
S
S
Cowen
D
D
D000704:Analysis of Variance; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D002296:Carcinosarcoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000556:secondary / Q000628:therapy; D003131:Combined Modality Therapy / Q000379:methods; D036821:Endometrial Stromal Tumors / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000556:secondary / Q000628:therapy; D005260:Female; D005602:France; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D007890:Leiomyosarcoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000556:secondary / Q000628:therapy; D008175:Lung Neoplasms / Q000556:secondary; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology; D011379:Prognosis; D016016:Proportional Hazards Models; D011878:Radiotherapy / Q000009:adverse effects; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D016019:Survival Analysis; D014594:Uterine Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000628:therapy