Clinicopathological features and prognostic factors of the uterine sarcomas

Objective: Uterine sarcomas, are rare, malignant and aggressive tumors of the uterus. In this study we aimed to evaluate retrospectively the clinical and pathologic features and to investigate the prognostic factors of the uterine sarcoma patients who were treated in our department in the last 20 years.Material and Methods: The archive files, medical and pathological records of the 132 uterine sarcoma patients who were operated on and regularly followed up in our 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 and overall survival were calculated using Kaplan-Meier and Cox regression tests. p value was taken <0.05 for the statistical significance level among all results.Results: Seventy of the patients were diagnosed with leiomyosarcomas, 33 with carcinosarcomas, 12 with endometrial stromal sarcomas, 9 with undifferentiated endometrial sarcomas, 5 with adenosarcomas and 3 of the cases with botryoid rhabdomyosarcomas. The average of the patients? age was 53,7±12,6 (17-78). About 2/3 of the patients were in the postmenopausal and 1/3 of them in the 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 was performed for most of them (88%). The mean duration of follow-up was 36 months (4-198). The 2 and 5 years total survival rates were 65% and 36% respectively, with a median time of 37 months (95% CI, 28-45). The 2 and 5 years disease-free survival 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 and lymphadenectomy were found to be independent prognostic factors affecting disease-free survival, only stage was detected as independent prognostic factor for overall survival.