Clinical and Pathologic Characteristics of Uterine Sarcoma

Kim, Jong Hyeok; Chang, Young Woo; Na, Jun Hee; Chun, Dae Joon; Kong, Hun Sik; Kim, Yong Man; Kim, Young Tak; Nam, Joo Hyun; Mok, Jung Eun

Abstract

Uterine sarcomas are rare, characterized by rapid clinical progression and poor prognosis, and their management has been a challenge. The purpose of this study was to investigate the clinical and pathologic characteristics of patients with uterine sarcoma managed in the department of Obstetric and Gynecology, college of medicine, University of Ulsan, Asan Medical center, Seoul, Korea from June 1989 to August 1998. Data including clinical and histologic findings, treatment and outcome of nineteen patients were evaluated. The age of patients ranged 22 to 71 years (mean+/-S.D.; 46.9+/-13.1) and half of patients were postmenopausal and four patients were nulliparous. Palpable pelvic mass or abnormal uterine bleeding were the most common sign or symptom. Twelve patients (63.2%) had stage I disease and seven (36.8%) had stage III disease. There were 13 cases (68.4%) of leiomyosarcoma, 4 cases (21.1%) of endometrial stromal sarcoma, 2 cases (10.5%) malignant mixed mullerian tumor. All except one received hysterectomy (simple or radical) with or without bilateral salpingo-oophorectomy. Some received omentectomy or pelvic lymphadenectomy. Postoperative chemotherapy was administered in ten patients with regimen of VAC, VBP, VIC and etc. The mean follow-up duration was 29.3 (+/- 24.7) months and 5 patients died of the disease resulting 2-year survival of 68.1%. FIGO stage and mitotic count were considered to have prognostic significance, but without statistical confirmation. In conclusion, uterine sarcomas are aggressive tumors with a poor prognosis. Our data showed excellent outcome in early disease with surgery with or without adjuvant chemotherapy, whereas there was no long-term survivor in advanced disease despite postoperative chemotherapy.