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Uterine sarcomas – an evaluation of treatment results and prognostic factors
Archives of Medical Science, 07/31/09

Karolewski K et al. – In a study to evaluate the efficacy of surgery plus adjuvant radiotherapy in 98 uterine sarcoma (US) pts and to analyse reasons for treatment failure and prognostic factors in those pts, it appears that combined surgery plus radiotherapy was a relatively effective therapy only in treatment of early stage US (stages I and II). Independent prognostic factors were stage and microscopic type of sarcoma. The reason for failure of combined treatment in the group of leiomyosarcoma (LMS) pts was the spread of malignancy, while in endometrial stromal sarcoma (ESS) pts it was regional recurrence.

Methods

Between 1980 and 2000, 98 pts with US were treated with surgery followed by postoperative radiotherapy.
This group consisted of 70 pts with LMS and 28 pts with ESS.

Results

5-yr survival rate with no evidence of disease (NED) was 49% for 98 US pts.
In the ESS subgroup, 5-yr survival rate with NED was 75% and in the LMS subgroup only 38.6%.
Analysis of outcomes based on stage of disease revealed that in the early stage group (FIGO stages I and II) 60.8% of US pts survived for 5 yrs with NED, whereas in locally advanced stages (stages III, IVA) only 12.5% survived for 5 yrs with NED.
In the LMS subgroup, the dominant reason for treatment failure was distant metastases, while in the ESS subgroup, there were locoregional recurrences.

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