title: Outcome analysis in patients with uterine sarcoma.
abstract: OBJECTIVE
  To analyze the prognostic factors for survivals and to evaluate the impact of postoperative whole pelvic radiotherapy (WPRT) on pelvic failure in patients with uterine sarcoma treated with radical surgery.
  
  
  METHODS
  We retrospectively analyzed 75 patients with uterine sarcoma who underwent radical surgery with (n = 22) or without (n = 53) radiotherapy between 1990 and 2010. There were 23 and 52 patients with carcinosarcoma and non-carcinosarcoma (leiomyosarcoma, 22; endometrial stromal sarcoma, 25; others, 5), respectively. The median follow-up period was 64 months (range, 17 to 269 months).
  
  
  RESULTS
  The 5-year overall survival (OS) and pelvic failure-free survival (PFFS) of total patients was 64.2% and 83.4%, respectively. Multivariate analysis revealed that mitotic count (p = 0.006) was a significant predictor of OS. However, factors were not found to be associated with PFFS. On analyzing each of the histologic subtypes separately, postoperative WPRT significantly reduced pelvic failure in patients with carcinosarcoma (10.0% vs. 53.7%; p = 0.046), but not in patients with non-carcinosarcoma (12.5% vs. 9.9%; p = 0.866). Among the patients with carcinosarcoma, 4 patients (17%) had recurrence within the pelvis and 3 patients (13%) had recurrence in other sites as an initial failure, whereas among the patients with non-carcinosarcoma, 3 patients (6%) experienced pelvic failure and 13 patients (25%) experienced distant failure.
  
  
  CONCLUSIONS
  The most significant predictor of OS was mitotic count. Based on the improved PFFS after postoperative WPRT only in patients with carcinosarcoma and the difference in patterns of failure between histologic subtypes, optimal adjuvant treatment options should be offered to patients based on the risk of recurrence patterns.
authors: Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea.
authors: Tosol
authors: T
authors: Yu
authors: Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea. ; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors: Hak Jae
authors: HJ
authors: Kim
authors: Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea. ; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors: Hong-Gyun
authors: HG
authors: Wu
authors: Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea. ; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors: Sung Whan
authors: SW
authors: Ha
authors: Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea. ; Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
authors: Yong-Sang
authors: YS
authors: Song
authors: Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea. ; Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
authors: Noh-Hyun
authors: NH
authors: Park
authors: Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea. ; Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
authors: Jae-Won
authors: JW
authors: Kim
keywords: Adjuvant radiotherapy; Neoplasms by histology type; Pelvic failure; Sarcoma; Uterus