Uterine sarcoma. Clinico-pathological characteristics and outcome

ABSTRACT

To investigate the clinical and histopathological characteristics, with the prognostic factors, treatment outcome, pattern of relapse, and survival analysis of uterine sarcoma patients. All patients with histologically proven uterine sarcoma were identified using the database at King Abdulaziz University Hospital, Jeddah, Saudi Arabia between January 2000 and December 2012. A total of 36 patients with uterine sarcoma were reviewed. The median age of all patients was 57 years, and the mean age was 57.72 +/- 13.17 years. Carcinosarcoma was reported in 21 patients [58%], leiomyosarcoma in 7 [19%], undifferentiated endometrial sarcoma in 6 [17%], and rhabdomyosarcoma in 2 [6%]. Approximately half of the patients were stages III and IV [28% and 25%], while 15 patients [41%] were stage I; only 2 patients [6%] were stage II. The surgical treatment was hysterectomy and bilateral salpingoophorectomy [H+BSO] plus staging in 18 patients [50%], while in 4 patients [19%], H+BSO plus debulking was performed. Adjuvant chemotherapy was given in 24 [69%] and adjuvant radiotherapy in 5 [14%] cases, At a median follow-up period of 13.5 months, 8 patients [22%] relapsed. The 2-year disease-free survival [DFS] rate was 22% and the 5-year was 14%. In the multivariate analysis, the advanced stages [p=0.015] and lymph vascular invasion [p=0.0001] were associated with poor DFS, while the use of chemotherapy significantly improved the DFS [p=0.027]. The poor outcome of high-grade uterine sarcoma patients was identified, and only one third of patients [30%] survived for 2 years. This finding necessitates the need for more aggressive tools to fight this disease