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Clinicopathological features and prognostic factors of the uterine sarcomas: 20 years of experience at Çukurova Usniversity
1 Department of Obstetrics and Gynecology, Faculty of Medicine, Çukurova University, Adana
2 Department of Pathology, Faculty of Medicine, Çukurova University, Adana (Turkey)
Eur. J. Gynaecol. Oncol. 2014, 35(6), 646–654; https://doi.org/10.12892/ejgo25032014
Published: 10 December 2014
Objective: Uterine sarcomas (US) are rare, malignant, and aggressive tumors of the uterus. In this study the authors aimed to evaluate retrospectively the clinical and pathologic features and to investigate the prognostic factors of the US patients who were treated in their department in the last 20 years. Materials and Methods: The archive files, medical, and pathological records of the 132 US patients who were operated on and regularly followed up in the clinic between March 1991 – March 2011 were reviewed. Clinical features, operation characteristics, pathological findings, adjuvant therapies, and follow-up data of the patients and their effects on survival were investigated. Analysis of disease-free survival (DFS) and overall survival (OS) were calculated using Kaplan-Meier and Cox regression tests. The p value was taken < 0.05 to maintain the statistical significance level for all results. Results: Seventy of the patients were diagnosed with leiomyosarcomas (LMS), 33 were with carcinosarcomas, 12 were with endometrial stromal sarcomas (ESS), nine were with undifferentiated endometrial sarcomas, five were with adenosarcomas, and three were with botryoid rhabdomyosarcomas. The average patients’ age was 53,7±12,6 (17-78). Aboutywo-thirds of the patients were in postmenopausal and one-third were in premenopausal period. Vaginal bleeding was detected as the most common reason for patients’ admission (68,9%). All cases underwent surgery and a procedure of total abdominal hysterectomy + bilateral salpingo-oophorectomy (TAH + BSO) was performed for most of them (88%). The mean duration of follow-up was 36 months (4-198). The two- and five-year OS rates were 65% and 36%, respectively, with a median time of 37 months (95% CI, 28-45). The two- and five-year DFS rates were 59% and 33%, respectively, with a median time of 29 months (95% CI, 18-40). Conclusion: As a result of multivariate analysis, while age, stage, lymphovascular space invasion (LVSI), and lymphadenectomy were found to be independent prognostic factors affecting DFS, only stage was detected as an independent prognostic factor for OS.
Endometrial stromal sarcoma