Preoperative Diagnosis and Treatment Results in 106 Patients with Uterine Sarcoma in Hokkaido, Japan

Abstract

Objective: The aim of this study was to evaluate the clinicopathological features of uterine sarcoma in Hokkaido, Japan, between 1990 and 1999, and to identify prognostic factors of patients with such malignancies in this area and period. Methods: One hundred and six patients with histologically proven uterine sarcoma were evaluated retrospectively. Results: 93.5% of the patients with carcinosarcoma (CS) were diagnosed as having malignant disease preoperatively, while 65% of those with leiomyosarcoma (LMS) and 75% of those with endometrial stromal sarcoma (ESS) were preoperatively diagnosed as benign leiomyoma. When patients had no residual disease postoperatively, 5-year survival rates in patients with CS and LMS were 78.8 and 73.0%, respectively. ESS cases had a better prognosis (94.7% for stage I cases). In patients with early-stage sarcoma, pelvic lymphadenectomy and adjuvant chemotherapy, with or without cis-diamminedichloroplatinum, failed to show a survival benefit in both CS and LMS cases. Distant metastasis, myometrial invasion, and no residual disease at surgery were significantly associated with risk of death or recurrence in CS and LMS cases. Conclusion: Accurate preoperative diagnosis of uterine sarcoma was difficult, and no residual disease at surgery was the most important prognostic factor in patients with this disease. Postoperative adjuvant therapy had little effect on survival , especially in early-stage disease.

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

“…S o m e s t u d i e s r e p o r t e d t h a t t u m o r g r a d e (Ghaemmaghami et al, 2008), tumor size (George et al, 1986;Rovirosa et al, 2002;Benito et al, 2009), depths of myometrial invasion (Rovirosa et al, 2002;Sagage et al, 2004;Park et al, 2008), LVSI (Major et al, 1993;Rovirosa et al, 2002;Park et al, 2008) had significant effect on prognosis of uterine sarcomas. In our study grade had significant effecet on RFS and OS.…”

A retrospective study on combination therapy with ifosfamide, adriamycin and cisplatin for progressive or recurrent uterine sarcoma

“…Yamawaki et al (6) reported that IAP was effective in a case with progressive UES. Yamaguchi et al (23) also reported that the rate of PR with IAP therapy for uterine sarcomas was 40.0% in the first-line and 9.1% in the second-line chemotherapy setting.…”

“…High-grade ESS, in particular, is referred to as undifferentiated endometrial sarcoma (UES). Total hysterectomy and bilateral salpingo-oophorectomy (BSO) are currently considered the first choice for the treatment of uterine sarcomas, although a consensus has not been reached regarding retroperitoneal lymphadenectomy (5,6). However, these tumors cannot be sufficiently controlled by surgical treatment alone, since a number of patients develop progression and recurrence of uterine sarcoma.…”

Intravenous low-grade endometrial stromal sarcoma with intracardiac extension: A CASE OF inaccurate tumor location on contrast-enhanced computed tomography

“…In the Japanese population, 13-19% of these tumors are classified as endometrial stromal sarcoma (ESS) (2,3). Due to the changes in the World Health Organization classification in 2003, which classified high-grade ESS as undifferentiated endometrial sarcoma (4), low-grade ESS (LG-ESS) may simply be referred to as ESS in some cases, although the classification reverted to its original form in 2014 (5).…”