The retrospective analysis of patients with uterine sarcomas: A single-center experience

Terek, Mustafa Coşan; Akman, Levent; Hurşitoğlu, Behiye Seda; Şanlı, Ulus Ali; Özsaran, Zeynep; Tekindal, Mustafa Agâh; Dikmen, Yılmaz; Zekioğlu, Osman; Özsaran, Ahmet

doi:10.4103/0973-1482.148698

Cited by 4 publications

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“…Several prognostic factors have been recognized from retrospective data to guide therapeutic decisions for uterine sarcoma patients. Patients with old age, advanced stage, high tumor grade, and high mitotic index have been found to have worse prognosis [ 13 , 14 , 15 , 16 ]. However, diagnosis and treatment of uterine sarcoma remain unclear.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Neutrophil-to-Lymphocyte Ratio as a Prognostic Factor in Uterine Sarcoma

Jeong

Park

Hur

et al. 2020

JCM

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Background: Recent studies have demonstrated that the tumor microenvironment, known to be influenced by inflammatory cells, plays a crucial role in cancer progression and clinical outcome of patients. The objective of the present study was to investigate prognostic values of preoperative neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) for disease-free survival (DFS) and overall survival (OS) of uterine sarcoma patients. Methods: Ninety-nine patients with uterine sarcoma treated in eight multicenter institutions over the last 20 years were retrospectively analyzed. Curves of DFS and OS were calculated using the Kaplan–Meier method, and univariate and multivariate analyses of various prognostic factors were performed using a Cox proportional hazard regression model. Results: High NLR was significantly associated with worse DFS (p = 0.007) and OS (p = 0.039). Advanced stage (p = 0.017) and high mitotic index (p = 0.036) retained their prognostic significance for DFS. Other clinical variables, including PLR, CA125, and lactate dehydrogenase (LDH) failed to show significant impact. Conclusions: Our findings showed that an elevated preoperative NLR was associated with poor clinical outcome in uterine sarcoma patients. Our results suggest that high NLR in early-stage uterine sarcoma patients might indicate that such patients need more intensive treatments.

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Section: Discussionmentioning

confidence: 99%

Preoperative Neutrophil-to-Lymphocyte Ratio as a Prognostic Factor in Uterine Sarcoma

Jeong

Park

Hur

et al. 2020

JCM

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“…In the literature, there is a little evidence that supports the use of adjuvant chemotherapy for sarcomas, except for CS. On the other hand, Terek et al reported that adjuvant chemotherapy is a significant prognostic factor for survival in uterine sarcomas [20].…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors and survival outcomes of uterine sarcomas in a reference gynecologic oncology cancer center

Demirtaş¹,

Gökçü²

2021

Journal of Surgery and Medicine

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Background/Aim: Uterine sarcomas are rare and aggressive tumors, and their clinical behavior is unpredictable. A clear-cut clinical course, proven treatment method or definitive prognostic factors affecting the survival of sarcoma patients are not reported in the literature. We aim to evaluate uterine sarcomas, determine clinicopathologic features, adjuvant therapies, and prognostic factors on survival while sharing our experience of these rare uterine tumors in light of the literature. Methods: This retrospective cohort study was conducted in Tepecik Training and Research Hospital, Izmir, Turkey between 2002-2020. Out of the total of 205 uterine sarcoma patients, 173 patients who underwent surgical procedures and were followed up in our hospital's Gynecologic Oncology Clinic were included in the study. Data of patients were collected from the hospital database. Surgical interventions, clinicopathologic features, adjuvant therapies, and overall and disease-free survivals were evaluated. Patients were grouped as leiomyosarcoma (LMS), carcinosarcoma (CS), endometrial stromal sarcoma (ESS), adenosarcoma (AS), and undifferentiated sarcoma (US). Results: The mean age of the patients was 57.6 (11.2) years. According to the International Federation of Gynecology and Obstetrics (FIGO2009), 115 patients (66.5%) had stage 1, 17 patients (9.8%) had stage 2, 31 (17.9%) patients had stage 3, and 10 patients (5.8%) had stage 4 disease. One hundred and sixty-two patients (93.6%) received adjuvant therapy. Median follow-up period was 39 months (range 3-214). The 120-month OS for the entire group was 87.1%. Conclusion:Stage is a significant prognostic factor for survival in all sarcoma types and recurrence is a significant prognostic factor for survival for LMS and CS patients. Sarcoma type and adjuvant treatments have no impact on survival. ESS patients require extended surgical staging.

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“…Furthermore, the SEER database also suffers several limitations, such as missing data on grade and stage, unreliable information on cause of death, and potential selection bias. Chemotherapy is also used for the adjuvant treatment of uterine sarcomas, and may improve survival [25]. However, the SEER database does not incorporate information on the use of chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Outcome of adjuvant radiotherapy after total hysterectomy in patients with uterine leiomyosarcoma or carcinosarcoma: a SEER-based study

Ren

Wang

2019

BMC Cancer

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Background The clinical impact of adjuvant radiotherapy on uterine sarcoma is unclear, and may depend on the histological type. Hence, the aim of this study was to evaluate clinical outcomes of adjuvant radiotherapy after total hysterectomy in patients with leiomyosarcoma or carcinosarcoma. Methods Data were obtained from the Surveillance, Epidemiology, and End Results (SEER) program. Cox proportional hazards regression analyses were performed to identify risk factors for overall mortality and cancer-specific mortality. In addition, a 1:1 propensity score matching approach was performed, in which age group, disease stage, tumor grade, tumor size, and lymphadenectomy status were matched. Results A total of 566 leiomyosarcoma and 1069 carcinosarcoma patients with stage I-III disease were included. Both regular Cox regression analysis and propensity score matching analysis revealed that utilization of adjuvant radiotherapy did not affect overall and cancer-specific mortality in patients with leiomyosarcoma. In contrast, for patients with carcinosarcoma, total mortality risk was significantly decreased with EBRT, brachytherapy, and combination radiotherapy compared with no radiotherapy. Cancer-specific mortality risk was significantly decreased with brachytherapy and combination radiotherapy as compared with no radiotherapy. Propensity score matching analyses revealed similar results in overall mortality, but not cancer-specific mortality, in patients with carcinosarcoma. Furthermore, the frequency of patients who did not receive any form of adjuvant radiotherapy was four times higher than those underwent adjuvant radiotherapy. Conclusions Adjuvant radiotherapy may provide a survival benefit for uterine carcinosarcoma, but not leiomyosarcoma. In addition, adjuvant radiotherapy is underutilized, and increased utilization of adjuvant radiotherapy may improve the survival rate of patients with carcinosarcoma. Electronic supplementary material The online version of this article (10.1186/s12885-019-5879-7) contains supplementary material, which is available to authorized users.

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The retrospective analysis of patients with uterine sarcomas: A single-center experience

Abstract: Although limited by small sample size and retrospective nature, age under 50 years, stage of disease, and adjuvant chemotherapy are significant prognostic factors for survival for uterine sarcomas.

Cited by 4 publications

References 0 publications

Preoperative Neutrophil-to-Lymphocyte Ratio as a Prognostic Factor in Uterine Sarcoma

Preoperative Neutrophil-to-Lymphocyte Ratio as a Prognostic Factor in Uterine Sarcoma

Prognostic factors and survival outcomes of uterine sarcomas in a reference gynecologic oncology cancer center

Outcome of adjuvant radiotherapy after total hysterectomy in patients with uterine leiomyosarcoma or carcinosarcoma: a SEER-based study

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