Uterine sarcoma: Clinical findings of 8 Cases

Park, Ji Kwon; Baek, Jong Chul; Chang, In Suk; You, Kyoung Sun; Shin, Jeong Kyu; Lee, Soon Ae; Lee, Jong Hak; Paik, Won Young

Abstract

OBJECTIVE
Uterine sarcoma is relatively rare tumor of mesodermal origin, and constitutes 2% to 6% of uterine malignancies. It is the most malignant group of gynecologic tumors and presents difficult problems in regard to diagnosis and management. The purpose of this study is to investigate the clinicopathologic findings and outcome of patients with uterine sarcoma.
METHODS
From March 1990 to March 2004, 8 patients were evaluated with histologically proven uterine sarcoma at department of obstetrics and gynecology of Gyeongsang University Hospital for their clinical profiles and survival retrospectively.
RESULTS
The age of patients with uterine sarcoma ranged 39 to 71, and the mean age was 58.4 years. The common presenting symptoms were abnormal uterine bleeding, abdominal pain and lower abdominal palpable mass. Using the FIGO classification: two patients had stage I, one patients had stage II, two patients had stage III, three patients had stage IV disease. Four patients were treated with surgery followed by postoperative adjuvant chemotherapy and/or radiotherapy, three patients were treated surgery alone, and one patient was treated with radiotherapy alone. Recurrences were revealed at two patients, and the sites were pelvis and brain. The mean duration of follow up was 25.1 months and the overall 2 years survival rate was 25%. The most common pathologic type of uterine sarcomas was leiomyosarcoma. MMMT (malignant mixed mullerian tumor) showed worse prognosis than LMS (leiomyosarcoma) or ESS (endometrial stromal sarcoma).
CONCLUSION
Uterine sarcoma are aggressive tumors with a poor prognosis. Age and stage were significant prognostic factor. The primary treatment modality has been surgical resection. The role of adjuvant chemotherapy and radiotherapy have not get been clearly defined and further large scaled multicentric studies are needed.