A Clinical Study of 40 Cases of Uterine Sarcoma

Lee, E H; Yang, S J; Lee, J G; Kim, C W; Ryu, S Y; Kim, J H; Kim, B G; Park, S Y; Rhee, E D; Lee, K H

Abstract

OBJECTIVE
Uterine sarcomas are rare tumors of mesodermal origan and comprise 2~6% if uterine malignancy. They are the most malignant group of gynecologic tumors and present intriguing problems in regard to diagnosis, and management. The purpose of this study was to investigate the clinicopathologic findings and outcome of patients with uterine sarcoma.
METHODS
From Jan. 1985 to Dec. 1997, 40 patients with histologically proven uterine sarcoma at Korea Cancer Center Hospital were evaluated for their clinical profiles and survival retrospectively.
RESULTS
Malignant mixed m llerian tumor [MMMT] was the most common uterine sarcoma [20/40 cases, 50%], followed by leiomyosarcoma [LMS] [12/40 cases, 30%] and endometrial stromal sarcoma [ESS] [8/40 cases, 20%]. Mean age of these patients was 52 years, and the most common presenting symptom was abnormal vaginal bleeding. There were no statistical differences in stage and presenting symptom, but MMMT was prevalent in older age than LMS and ESS. Most of the patients were treated by surgery followed by post-operative adjuvant chemotherapy or radiation [57.5%], but nine patients [30%] were treated with surgery alone. The overall 5-year survival rate was 37.9%, and MMMT showed worse prognosis than LMS or ESS [17.7%, 52.3% and 75% respectively] [p<0.01]. Age and stage were significant prognostic factors, and adjuvant treatment did not affect the survival of patients.
CONCLUSION
Uterine sarcomas are aggressive tumors with a poor prognosis. The role of adjuvant chemotherapy or radiation still remains undeterimined and further large scaled multicenter studies are needed.