Management of uterine sarcomas and prognostic indicators: real world data from a single-institution

• Main Authors: Anastasios Kyriazoglou, Michael Liontos, Dimitrios C Ziogas, Flora Zagouri, Kostantinos Koutsoukos, Giorgos Tsironis, Anna Tsiara, Maria Kaparelou, Roubini Zakopoulou, Nikolaos Thomakos, Dimitrios Haidopoulos, Irene Papaspyrou, Alexandros Rodolakis, Aristotelis Bamias, Meletios Athanasios Dimopoulos
• Format: Article
• Language: English
• Published: BMC 2018-12-01
• Series: BMC Cancer
• Subjects: Uterine sarcomas; Prognostic factors; Mitotic index
• Online Access: http://link.springer.com/article/10.1186/s12885-018-5156-1

Abstract Background Uterine sarcomas consist a heterogeneous group of mesenchymal gynecological malignancies with unclear therapeutic recommendations and unspecific but poor prognosis, since they usually metastasize and tend to recur very often, even in early stages. Methods We retrospectively analyzed all female patients with uterine sarcomas treated in our institution over the last 17 years. Clinico-pathological data, treatments and outcomes were recorded. Kaplan-Meier curves were plotted and time-to-event analyses were estimated using Cox regression. Results Data were retrieved from 61 women with a median age of 53 (range: 27–78) years, at diagnosis. Fifty-one patients were diagnosed with leiomyosarcoma (LMS), 3 with high grade endometrial stromal sarcoma (ESS), 5 with undifferentiated uterine sarcoma (UUS), 1 with Ewing sarcoma (ES) and 1 with Rhabdomyosarcoma (RS). 24 cases had stage I, 7 stage II, 14 stage III and 16 stage IV disease. Median disease-free survival (DFS) in adjuvant approach was 18.83 months, and median overall survival (OS) 31.07 months. High mitotic count (> 15 mitoses) was significantly associated with worse OS (P < 0.001) and worse DFS (P = 0.028). Conclusions Mitotic count appears to be independent prognostic factor while further insights are needed to improve adjuvant and palliative treatment of uterine sarcomas.