Uterine sarcomas in Siriraj Hospital (1991-2005).

ABSTRACT

Objective: To study the incidence, clinical characteristics, treatments and outcomes in patients with uterine sarcomas at Siriraj Hospital. Methods: A medical record search of patients treated at Siriraj Hospital from January 1991 to December 2005 was performed for clinical characteristics and treatments. Survival curves were generated using Kaplan-Meier method. Results: Sixty uterine sarcomas were diagnosed during a 15-year period. The mean age was 49.3 years (range 27-74; SD 10.6). Abnormal bleeding was the most common presenting symptom (40%). Only 11.7% of the cases could be diagnosed preoperatively. Of 60 patients, 37 (61.6%) had leiomyosarcoma (LMS), 9 (15%) had malignant mixed mullerian tumor (MMMT), and 14 (23.3%) had endometrial stromal sarcoma (ESS). The distribution by FIGO staging was as follows stage I 47.5%, stage II 15%, stage III 17.5%, and stage IV 20%. The treatment was mainly hysterectomy with adjuvant chemotherapy. The median follow-up time was 25 months. The five-year survival rate was 55.4%. Conclusion: The incidence of uterine sarcoma at Siriraj Hospital was 4.4% of uterine malignancies. The most common histologic type was leiomyosarcoma (61.6%). The common presenting symptoms were uterine bleeding and pelvic mass. In most cases, the treatment modality was surgery combined with chemotherapy. The overall 5-year survival rate of the studied group was 55.4%.