Evaluation of treatment results and prognostic factors of uterine sarcoma: A single-center experience

Abstract

Background: Uterine sarcomas (US) constitute a rare heterogeneous group of gynecological malignancies with aggressive characteristics and poor prognosis. Identifying the histopathological factors that determine the prognosis of the tumor and efficacy of various treatment modalities provides a reliable source for efficient treatment of affected patients. This study presents our 11-year experience with US in the south of Iran. Methods: Medical records of 42 patients (2001-2012) with endometrial stromal sarcoma (ESS), leiomyosarcoma (LMS), and malignant mixed Müllerian tumor (MMMT) were investigated. Hazard ratio (HR) and 2- and 5-year survival of patients were analyzed based on the patients’ age, histopathological characteristics (tumor type, stage, necrosis, and mitotic index), and treatment modalities. Results: Twenty-four patients survived with median follow-up of 42.5 months; 18 died within 17 months, and 52.4% had recurrence, of whom 12 died. Two- and five-year survival rate was 78.6% and 61.9%, respectively, longest for ESS and shortest for MMMT. Higher age, tumor stage, necrosis, and mitotic index increased the HR of mortality. Radiotherapy resulted in a better survival, compared with chemotherapy alone or combined with radiotherapy. Conclusion: Although ESS had the best prognosis, MMMT was the most aggressive tumor with the shortest survival time. Histological type of the tumor, staging, tumor necrosis, and mitotic index had prognostic roles. Adjuvant radiotherapy resulted in a better survival, compared with surgery alone in early stage.

Clinicopathological characteristics and prognosis of uterine sarcoma: A retrospective 10-year single-center study in China

“…The univariate analysis showed that over 50 years, post-menopause, advanced stage, and ≥1/2 myometrial invasion were signi cantly associated with poorer survival; while multivariable analysis demonstrated that post-menopause and advanced stage were independent prognostic factors for survival of the total cohort and the LMS group. These ndings were consistent with previous studies showing higher incidence and poorer prognosis of uterine sarcoma in postmenopausal women, women aged >50 [19,20] and with advanced tumor stages [14,21]. Our study showed that the 5-year survival rate of ESS was as high as 84.9%, which was similar to the reported survival rate of 75% in an Iran study with 42 patients [21].…”

Clinicopathological Profile, Surgical Practices and Outcomes of the Patients with Uterine Sarcoma: A Single Institutional Study from Eastern India

“…13 Longest survival was reported for ESS and shortest for carcinosarcoma in a retrospective study on 42 patients. 11 Older age, advanced stage, presence of necrosis, and high mitotic index increased the hazard ratio of mortality. 11 From the results of our study, the median survival of patients with LGESS, LMS, HGESS, UES, AS, and STUMP were 32, 11, 4, 9.5, 26, and 42 months, respectively, and the median DFS for the entire cohort of uterine sarcoma was 32 months, and the median OS was 57 months.…”

“…11 Older age, advanced stage, presence of necrosis, and high mitotic index increased the hazard ratio of mortality. 11 From the results of our study, the median survival of patients with LGESS, LMS, HGESS, UES, AS, and STUMP were 32, 11, 4, 9.5, 26, and 42 months, respectively, and the median DFS for the entire cohort of uterine sarcoma was 32 months, and the median OS was 57 months. The better survival in this study may be attributed to the following reasons: Patients diagnosed with carcinosarcoma were excluded, most of the patients were managed in early stages, and LGESS was the most common histological type encountered which naturally had a better prognosis when compared to other histological subtypes.…”

“…10 Elderly age group, black race, size of the tumor, and the presence of extrauterine metastasis at the time of diagnosis were the factors affecting the survival. 11 Due to its rarity and diversity in the histological types, the common consensus on risk factors associated with poor outcomes and standard treatment is not available. The aim of the study is to analyze the clinicopathological profile, surgical practices, and survival outcomes of patients diagnosed with uterine sarcoma.…”

Inibidores da via de sinalização do Sonic hedgehog: avaliação de seus efeitos in vitro em leiomioma e leiomiossarcoma uterinos

“…Os LM são comumente tratados com medicamentos hormonais, anti-inflamatórios e suplemento de vitaminas e ferro por conta dos nutrientes perdidos no sangramento (Hajhashemi et al, 2019;Bradley et al, 2019;Archer et al, 2017). Já os LMS, a principal opção terapêutica é a remoção uterina seguida por terapia adjuvante como radioterapia ou quimioterapia, com o objetivo de evitar recidiva e metástase (Momtahan et al, 2019). Tendo em vista as alternativas oferecidas até o presente momento, estudos que possibilitem a identificação de novas opções terapêuticas para ambos tumores, apresentam efeito benéfico para as pacientes.…”