Prognostic factors for uterine sarcoma

Introduction Uterine Sarcomas (US) as a histologically heterogeneous group of highly malignant tumors are very rare (1.5-3/100000), aggressive and associated with a poor prognosis. They account for approximately 3-7 % of uterine malignancies. Aim is to assess prognostic factors for patients with US.

Methodology A total of 58 patients diagnosed with US treated at university Tübingen from 01/2007 through 04/2018, were retrospectively analyzed.

Results Average age at presentation was 51.7 years (range, 21-78years); most frequent histology was leiomyosarcoma (LMS) in 31 (53,4 %) cases and most often FIGO stage I was diagnosed in 33 (56,9 %) cases. 10 patients (17,2 %) had distant metastases. Most common site was the lung. 14 patients (24,1 %) experienced local recurrence within a median time interval of 17 months (range, 2-63). 13 patients (22,4 %) died with a median overall survival (OS) of 22 months (range, 1-84). There was a statistically significant difference in OS between the histologic subtypes (p = 0,007). Patients with Low-Grade Endometrial Stromal Sarcoma had a 5-year OS of 95 %, in contrast to 82 % for LMS and only 27 % for High-Grade Endometrial Stromal Sarcoma (HG-ESS). FIGO stage influenced the OS significantly too (p = 0,048). For patients with stage I, II and IV the 5-year OS was 89 %, 70 % and 60 %, respectively.

Resection margins was the strongest prognostic factor (p < 0,001): by R0 the 5-year OS was 85 % and by R1 66 %.

Conclusion In our study, unfavorable OS was predominant in advanced FIGO stages, in HG-ESS and LMS subtype and suboptimal cytoreduction. Decisive is early diagnosis and optimal cytoreduction.

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Publication History

Article published online:
07 October 2020