Prognostic factors and treatment outcomes in 93 patients with uterine sarcoma from 4 centers in Turkey.
BACKGROUND
Uterine sarcomas are a group of heterogenous and rare malignancies of the female genital tract and there is a lack of consensus on prognostic factors and optimal treatment.


OBJECTIVE
To perform a retrospective evaluation of clinicopathological characteristics, prognostic factors and treatment outcomes of 93 patients with uterine sarcomas who were diagnosed and treated at 4 different centers from November 2000 to October 2010.


RESULTS
Of the 93 patients, 58.0% had leiomyosarcomas, 26.9% malignant mixed Mullerian tumors, 9.7% endometrial stromal sarcomas, and 5.4% other histological types. According to the last International Federation of Gynecology and Obstetrics (FIGO) staging, 43.0% were stage I, 20.4% were stage II, 22.6% were stage III and 14.0 % were stage IV. Median relapse free survival (RFS) was 20 months (95% confidence interval (CI), 12.4-27.6 months), RFS after 1, 2, 5 years were 66.6%, 44.1%, 16.5% respectively. Median overall survival (OS) was 56 months (95% CI, 22.5-89.5 months), and OS after 1, 2, 5 years was 84.7%, 78%, 49.4% respectively. Multivariate analysis showed that age≥60 years and high grade tumor were significantly associated with poor OS and RFS; patients administered adjuvant treatment with sequential chemotherapy and radiotherapy had longer RFS time. Among patients with leiomyosarcoma, in addition to age and grade, adjuvant treatment with sequential chemotherapy and radiotherapy after surgery had significant effects on OS.


CONCLUSIONS
Uterine sarcomas have poor progrosis even at early stages. Prognostic factors affecting OS were found to be age and grade.
Medical Oncology Department of Dr A.Y.Ankara Oncology Training and Research Hospital, Ankara, Turkey. aysadurnali@gmail.com
Ayşe
A
Durnali
Saadet
S
Tokluoğlu
Nuriye
N
Özdemir
Mevlüde
M
Inanç
Necati
N
Alkiş
Nurullah
N
Zengin
Özlem Uysal
ÖU
Sönmez
Mehmet
M
Küçüköner
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016889:Endometrial Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007890:Leiomyosarcoma / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D008875:Middle Aged; D018200:Mixed Tumor, Mullerian / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D018203:Sarcoma, Endometrial Stromal / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D015996:Survival Rate; D014421:Turkey; D014594:Uterine Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D055815:Young Adult