A Multicentre Retrospective Review of Clinical Characteristics of Uterine Sarcoma

Wais, Marta; Tepperman, Elissa; Bernardini, Marcus Q.; Gien, Lilian T.; Jiménez, Waldo; Murji, Ally

doi:10.1016/j.jogc.2017.03.090

Cited by 27 publications

(25 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The most frequent type of uterine sarcoma was LG-ESS, which was found in about 43.9% cases, followed by LMS (29.8%) and HG-ESS (11.4%), which was in line with earlier studies on the clinical characteristics of uterine sarcoma in China [11][12][13]. As ESS was the most common pathological subtype, 76.0% of which in premenopausal patients, and the average age of uterine sarcoma patients in the current study was lower than other retrospective studies [8][9]11]. The UUS group had the oldest average patient age, and most of which in postmenopausal patients, similar to the findings of a previous study [14].…”

Section: Discussionsupporting

confidence: 89%

“…Many studies have examined various preoperative diagnostic tools. Wais et al [9] identified 302 patients with uterine sarcoma, and 114 (51%) underwent preoperative endometrial sampling. Pathology suggested uterine sarcoma in 65% of cases.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with preoperative suspected uterine sarcoma should be referred to specialist centers where appropriate surgery can be performed. The lack of specific symptoms, signs, or diagnostic techniques for preoperative differentiation from uterine fibroids results in unexpected uterine sarcomas after surgery [8,9]. If a uterine sarcoma is mistakenly diagnosed as a uterine fibroid and is morcellated via laparoscopy, then serious consequences may arise [10].…”

Section: Ivyspringmentioning

confidence: 99%

See 2 more Smart Citations

A Real-World Study on Diagnosis and Treatment of Uterine Sarcoma in Western China

Li¹,

Yin

et al. 2020

Int. J. Biol. Sci.

View full text Add to dashboard Cite

Uterine sarcomas constitute a rare heterogeneous group of gynecological malignancies with aggressive characteristics and poor prognosis. They have similar clinical features to benign leiomyomata making them difficult to reliably identify prior to hysterectomy. The preoperative prediction of uterine sarcoma remains a clinical dilemma. The current study conducted a multicentre, retrospective study to examine the accuracy of preoperative diagnosis, the consequent influence on therapy, and survival factors in patients with uterine sarcoma in Western China. Four affiliated hospitals of the medical college in Western China over a six-year period. One hundred and fourteen patients diagnosed with low-grade endometrial stromal sarcoma (LG-ESS), high-grade endometrial stromal sarcoma (HG-ESS), undifferentiated uterine sarcoma (UUS), leiomyosarcoma (LMS), or adenosarcoma (AS) were analyzed. The median age at diagnosis was 47 years. Eighty (70.2%) patients were premenopausal and 34 (29.8%) post-menopausal. The most common pathological type was LG-ESS (43.9%). The diagnostic sensitivity of ultrasound for uterine malignant tumors was 11.0%, much lower than MRI (35.3%) and CT (63.0%). Unlike MRI, most of the patients who underwent CT (88.2%) examination were at the advanced stage. Forty-seven (41.2%) patients with uterine sarcoma were diagnosed with uterine malignant tumor before operation. Thirty-two (47.8%) patients who were misdiagnosed before operation needed reoperation and five patients (4.6%) diagnosed after radical surgery developed distant metastasis simultaneously. The recommended treatment of 87.0% of the patients with uterine sarcoma was total hysterectomy and bilateral salpingooophorectomy, and 53.7% of patients received adjuvant chemotherapy after operation. Pelvic lymph node status were clarified in 47 patients (43.5%), which were higher in HG-ESS and UUS groups, and lower in LMS group (P = 0.013). In univariate analysis, we found a significant association between tumour histological types, tumour stage, menstrual status, elevated preoperative neutrophil/lymphocyte ratio and overall survival. In multivariate analysis, we only observed a significant association between tumour histological types and tumour stage and overall survival.

show abstract

Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Ivyspringmentioning

confidence: 99%

See 1 more Smart Citation

A Real-World Study on Diagnosis and Treatment of Uterine Sarcoma in Western China

Li¹,

Yin

et al. 2020

Int. J. Biol. Sci.

View full text Add to dashboard Cite

show abstract

“…Age was a predictor of ULMS. A multicenter retrospective study reported 221 patients of ULMS and 81 patients of endometrial stromal sarcoma were diagnosed at an average age of 55 years old, and 59% were postmenopausal [7]. Hosh et al found that the age-adjusted incidence rate for patients aged 50 years or older was ULSM uterine leiomyosarcoma higher than younger patients (6.4/10 vs 1.5/10, P < 0.0001), based on Surveillance, Epidemiology, and End Results (SEER) database [8].…”

Section: Discussionmentioning

confidence: 99%

Preoperative clinical characteristics scoring system for differentiating uterine leiomyosarcoma from fibroid

Zhang

Zhu

et al. 2020

BMC Cancer

View full text Add to dashboard Cite

Background: Morcellation may lead to intraperitoneal spread of tumor cells, thus making prognosis of undiagnosed uterine leiomyosarcoma (ULMS) worse. However, preoperative diagnosis of ULMS remains challenging. This study aimed to design a preoperative clinical characteristics scoring system for differentiating ULMS from uterine fibroid. Methods: This study enrolled 45 ULMS patients and 180 uterine fibroid patients in Peking Union Medical College Hospital from January 2013 to December 2018. Results: The incidence of occult ULMS was 0.59% (95% CI, 0.39-0.71%). Age ≥ 40 years old (OR 2.826, 95%CI 1.326-5.461), tumor size ≥7 cm (OR 6.930, 95% CI 2.872-16.724), neutrophil-to-lymphocyte ratio (NLR) ≥ 2.8 (OR 3.032, 95%CI 1.288-7.13), number of platelet ≥298 × 10 9 /L (OR 3.688, 95%CI 1.452-9.266) and lactate dehydrogenase (LDH) ≥ 193 U/L (OR 6.479, 95%CI 2.658-15.792) were independent predictors of ULMS. A preoperative clinical characteristics scoring system was designed based on OR values, with a total score of 7 points. Tumor size ≥7 cm, LDH ≥ 193 U/L were assigned 2 points, while age ≥ 40 years old, NLR ≥ 2.8 and number of platelet ≥298 × 10 9 /L were assigned 1 point. Score ≥ 4 points was a useful predictor in diagnosing ULMS from fibroid (sensitivity 0.800, specificity 0.778). Conclusions: The incidence of occult ULMS was low. Age ≥ 40 years old, tumor size ≥7 cm, LDH ≥ 193 U/L, NLR ≥ 2.8 and number of platelet ≥298 × 10 9 /L were independent predictors of ULMS. The preoperative clinical characteristics scoring system could be helpful in preoperative diagnosis of occult ULMS.

show abstract

“…Quanto aos resultados do anatomopatológico das 33 pacientes apresentavam carcinoma endometrial, foram encontrados os seguintes tipos histológicos: 23 adenocarcinomas endometrióides, 6 carcinossarcomas, 1 adenocarcinoma seroso, 3 carcinomas de células escamosas. Duas pacientes apresentavam leiomiossarcoma, que é uma neoplasia maligna agressiva que também pode acometer mulheres na pós-menopausa e apresenta sangramento uterino anormal como sintoma mais comum (13) . Este é um estudo retrospectivo, portanto, tem limitações estatísticas.…”

Section: Discussionunclassified

Relação entre o espessamento endometrial e o sangramento uterino anormal no diagnóstico de câncer de endométrio em pacientes na pós-menopausa / Relationship among endometrial thickening and abnormal uterine bleeding in the diagnosis of endometrial cancer in postmenopausal patients

Jamur

Rodrigues

Schünemann

2019

Arq Med Hosp Fac Cienc Med Santa Casa São Paulo

View full text Add to dashboard Cite

Introdução: O câncer de endométrio é o terceiro câncer ginecológico mais frequente em mulheres no Brasil. O sangramento uterino anormal e o espessamento endometrial são as apresentações mais comuns da doença. O objetivo desse estudo foi encontrar a relação entre sangramento, espessamento endometrial e obesidade no diagnóstico do câncer de endométrio na paciente na pós-menopausa. Métodos: Trata-se de um estudo retrospectivo no qual foi realizado o levantamento de dados das pacientes na pós-menopausa submetidas à curetagem uterina de prova (CUP) devido à queixa de sangramento anormal e/ou apresentarem espessamento endometrial, no Hospital de Clínicas da UFPR no período de Janeiro de 2012 a Dezembro de 2014. Resultados: Das 157 pacientes na pós-menopausa avaliadas, foram diagnosticados 33 casos de câncer de endométrio e dois de sarcoma. Da amostra total (157), 112 apresentavam espessamento endometrial e sangramento, 40 somente espessamento e 5 somente sangramento. Das 112 com sangramento e espessamento, foram encontrados 31 (27,7%) casos de câncer de endométrio. Das 40 que apresentavam apenas espessamento, uma (2,5%) apresentou câncer. Das 5 que apresentavam sangramento isolado, foi diagnosticado um caso de câncer de endométrio (20%). A incidência de câncer de endométrio também mostrou relação com o aumento de IMC (com maior incidência acima de 25) e com o nível de espessamento endometrial a partir de 15mm. Conclusão: O sinal mais importante relacionado ao câncer de endométrio, sem dúvida é o sangramento. Mulher no período da pós-menopausa que apresente sangramento uterino anormal deve ser investigada criteriosamente em busca de exclusão de diagnóstico oncológico, pela alta possibilidade (OR = 14.03) de ter câncer de endométrio.Descritores: Neoplasias do endométrio, Metrorragia, Hemorragia uterina, Pós-menopausa, Obesidade, CuretagemAbstractIntroduction: Endometrial cancer is one of the most common types of gynecological cancer, and it is the fourth leading cause of death by cancer among women in Brazil. Abnormal uterine bleeding and endometrial thickening are the most frequent presentations of this disease. The objective of this study was to find the relationship among abnormal bleeding, thickening and obesity in the diagnosis of endometrial cancer in postmenopausal patients. Methods: This is a retrospective study in which was collect data of patients that underwent uterine curettage (D&C) complaining about abnormal bleeding and/or presenting endometrial thickening, at Hospital de Clínicas from UFPR on the period of January 2012 to December 2014. Results: From all the 157 postmenopausal patients evaluated, 33 cases of endometrial cancer and two of sarcoma were diagnosed. In the total sample (157), 112 presented endometrial thickening and bleeding, and 40 presented thickening and five presented isolated bleeding. Within the 112 patients with abnormal bleeding and endometrial thickening, 31 (27.7%) cases of endometrial cancer were found. From the 40 patients with only thickening, one (2.5%) presented cancer. From the five patient isolated bleeding, one (20%) case of endometrial cancer was diagnosed. The incidence of cancer also showed relationship with BMI increasing (mores incidence of cancer with BMI over 25) and with endometrial thickening starting from 15mm. Conclusion: The most important factor related to endometrial cancer beyond doubt is abnormal bleeding. Postmenopausal women with abnormal uterine bleeding should be carefully investigated for exclusion of an oncological diagnosis, because of the high possibility (OR = 14.03) of having endometrial cancer.Keywords: Endometrial neoplasms, Metrorrhagia, Postmenopause, Uterine hemorrhage, Obesity, Curettage

show abstract

A Multicentre Retrospective Review of Clinical Characteristics of Uterine Sarcoma

Cited by 27 publications

References 20 publications

A Real-World Study on Diagnosis and Treatment of Uterine Sarcoma in Western China

A Real-World Study on Diagnosis and Treatment of Uterine Sarcoma in Western China

Preoperative clinical characteristics scoring system for differentiating uterine leiomyosarcoma from fibroid

Relação entre o espessamento endometrial e o sangramento uterino anormal no diagnóstico de câncer de endométrio em pacientes na pós-menopausa / Relationship among endometrial thickening and abnormal uterine bleeding in the diagnosis of endometrial cancer in postmenopausal patients

Contact Info

Product

Resources

About