Prognostic Factors and Treatment Outcomes in 93 Patients with Uterine Sarcoma from 4 Centers in Turkey


Introduction: Uterine sarcomas are a group of heterogenous and rare malignancies of the female genitaltract and there is a lack of consensus on prognostic factors and optimal treatment. Objective and Methodology:To perform a retrospective evaluation of clinicopathological characteristics, prognostic factors and treatmentoutcomes of 93 patients with uterine sarcomas who were diagnosed and treated at 4 different centers fromNovember 2000 to October 2010.
Results: Of the 93 patients, 58.0% had leiomyosarcomas, 26.9% malignantmixed Mullerian tumors, 9.7% endometrial stromal sarcomas, and 5.4% other histological types. Accordingto 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 significantlyassociated with poor OS and RFS; patients administered adjuvant treatment with sequential chemotherapyand 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.
Conclusion: Uterine sarcomas have poor progrosis even at early stages. Prognostic factors affecting OS werefound to be age and grade.