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http://dx.doi.org/10.7314/APJCP.2012.13.5.1935

Prognostic Factors and Treatment Outcomes in 93 Patients with Uterine Sarcoma from 4 Centers in Turkey  

Durnali, Ayse (Medical Oncology Department of Dr A.Y.Ankara Oncology Training and Research Hospital)
Tokluoglu, Saadet (Medical Oncology Department of Guven Hospital)
Ozdemir, Nuriye (Medical Oncology Department of Ankara Numune Training and Research Hospital)
Inanc, Mevlude (Medical Oncology Department of Erciyes University Faculty of Medicine)
Alkis, Necati (Medical Oncology Department of Dr A.Y.Ankara Oncology Training and Research Hospital)
Zengin, Nurullah (Medical Oncology Department of Ankara Numune Training and Research Hospital)
Sonmez, Ozlem Uysal (Medical Oncology Department of Dr A.Y.Ankara Oncology Training and Research Hospital)
Kucukoner, Mehmet (Medical Oncology Department of Dicle University Faculty of Medicine)
Anatolian Society of Medical Oncology (ASMO), Anatolian Society of Medical Oncology (ASMO) (Anatolian Society of Medical Oncology (ASMO))
Publication Information
Asian Pacific Journal of Cancer Prevention / v.13, no.5, 2012 , pp. 1935-1941 More about this Journal
Abstract
Introduction: Uterine sarcomas are a group of heterogenous and rare malignancies of the female genital tract and there is a lack of consensus on prognostic factors and optimal treatment. Objective and Methodology: To perform a retrospective evaluation of clinicopathological characteristics, prognostic factors and treatment outcomes of 93 patients with uterine sarcomas who were diagnosed and treated at 4 different centers from November 2000 to October 2010. Results: Of the 93 patients, 58.0% had leiomyosarcomas, 26.9% malignant mixed Mullerian tumors, 9.7% endometrial stromal sarcomas, and 5.4% other histological types. According to the last International Federation of Gynecology and Obstetrics (FIGO) staging, 43.0% were stage I, 20.4% were stage II, 22.6% were stage III and 14.0 % were stage IV. Median relapse free survival (RFS) was 20 months (95% confidence interval (CI), 12.4-27.6 months), RFS after 1, 2, 5 years were 66.6%, 44.1%, 16.5% respectively. Median overall survival (OS) was 56 months (95% CI, 22.5-89.5 months), and OS after 1, 2, 5 years was 84.7%, 78%, 49.4% respectively. Multivariate analysis showed that age ${\geq}60$ years and high grade tumor were significantly associated with poor OS and RFS; patients administered adjuvant treatment with sequential chemotherapy and radiotherapy had longer RFS time. Among patients with leiomyosarcoma, in addition to age and grade, adjuvant treatment with sequential chemotherapy and radiotherapy after surgery had significant effects on OS. Conclusion: Uterine sarcomas have poor progrosis even at early stages. Prognostic factors affecting OS were found to be age and grade.
Keywords
Uterine sarcoma; leiomyosarcoma; malignant mixed Mullerian tumor; prognostic factors; Turkey;
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1 Hempling RE, Piver MS, Baker TR (1995). Impact on progression-free survival of adjuvant cyclophosphamide, vincristine, doxorubicin(adriamycin) and dacarbazine (CYVADIC) chemotherapy for stage I uterine sarcoma. A prospective tiral. Am J Clin Oncol, 18, 282-6.   DOI
2 Koivisto-Korander R, Butzow R, Koivisto AM, Leminen A (2008). Clinical outcome and prognostic factors in 100 cases of uterine sarcoma: experience in Helsinki University Central Hospital 1990-2001. Gynecol Oncol, 111, 74-81.   DOI   ScienceOn
3 Kokawa K, Nishiyama K, Ikeuchi M, et al (2006). Clinical outcomes of uterine sarcomas: results from 14 years worth of experience in the Kinki district in Japan (1990-2003). Int J Gynecol Cancer, 16, 1358-63.   DOI
4 Livi L, Paiar F, Shah N, et al (2003). Uterine sarcoma: twentyseven years of experience. Int J Radiat Oncol Biol Phys, 57, 1366-73.   DOI   ScienceOn
5 Major FJ, Blessing JA, Silverberg SG, et al (1993). Prognostic factors in early-stage uterine sarcoma. A Gynecologic Oncology Group study. Cancer, 71, 1702-9.   DOI
6 Matoda M, Takeshima N, Nomura H, et al (2011). The treatment of uterine leimyosarcoma: clinical outcomes of 18 cases and the efectiveness of chemotherapy. Eur J Gynaecol Oncol, 32, 647-50.
7 Menczer J, Levy T, Piura B, et al (2005). A comparison between different postoperative treatment modalities of uterine carcinosarcoma. Gynecol Oncol, 97, 166-70.   DOI
8 Odunsi K, Moneke V, Tammela J, et al (2004). Efficacy of adjuvant CYVADIC chemotherapy in early-stage uterine sarcomas: results of long term follow up. Int J Gynecol Cancer, 14, 659-64.   DOI
9 Olah KS, Dunn JA, Gee H (1992). Leimyosarcomas have a poorer prognosis than mixed mesodermal tumours when adjusting for known prognostic factors: the result of a retrospective study of 423 cases of uterine sarcoma. Br J Obstet Gynecol, 99, 590-4.   DOI
10 Olah KS, Gee H, Blunt S, et al (1991). Retrospective analysis of 318 cases of uterine sarcoma. Eur J Cancer, 27, 1095-9.   DOI
11 Omura GA, Bleesing JA, Major F, et al (1985). A randomized clinical trial of adjuvant adriamycin in uterine sarcomas: a Gynecologic Oncology Group study. J Clin Oncol, 3,1240-5.   DOI
12 Park J-Y, Kim D-Y, Suh D-S, et al (2008). Prognostic factors and treatment outcomes of patients with uterine sarcoma: analysis of 127 patients at a single institution, 1989-2007. J Cancer Res Clin Oncol, 134, 1277-87.   DOI
13 Pautier P, Genestie C, Rey A, et al (2000). Analysis of clinicopathologic prognostic factors for 157 uterine sarcomas and evaluation of a grading score validated for soft tissue sarcoma. Cancer, 88, 1425-31.   DOI
14 Peters WA 3rd, Kumar NB, Fleming WP, Morley GW (1984). Prognostic features of sarcomas and mixed tumors of the endometrium. Obstet Gynecol, 63, 550-6.
15 Prat J (2009). FIGO staging for uterine sarcomas. Int J Gynecol Obstet, 104, 177-8.   DOI   ScienceOn
16 Rovirosa A, Ascaso C, Ordi J, et al (2002). Is vascular and lymphatic space invasion a main prognostic factor in uterine neoplasms with a sarcomatous component? A retrospective study of prognostic factors of 60 patients stratified by stages. Int J Radiat Oncol Biol Phys, 52, 1320-9.   DOI
17 Schwartz SM, Thomas DB (1989). A case-control study of risk factorsfor sarcomas of the uterus. The World Health Organization Collaborative Study of Neoplasia and Steroid Contraceptives. Cancer, 64, 2487-92.   DOI   ScienceOn
18 Sagage S, Yamashita K, Ishioka S, et al (2004). Preoperative diagnosis and treatment results in 106 patients with uterine sarcoma in Hokkaido, Japan. Oncology, 67, 33-9.   DOI
19 Salazar OM, Dunne ME (1980). The role of radiation therapy in the management of uterine sarcomas. Int J Radiat Oncol Biol Phyis, 6, 899-902.   DOI
20 Sartori E, Bazzurini L, Gadducci A, et al (1997). Carcinosarcoma of the uterus: a clinicopathological multicenter CTF study. Gynecol Oncol, 67, 70-5.   DOI
21 Sharma DN, Rath GK, Kumar S, et al (2011). Clinical outcome of patients with uterine sarcomas. J Cancer Res Ther, 7, 270-4.   DOI
22 Sleijfer S, Seynaeve C, Verweij (2007). Gynaecological sarcomas. Curr Opin Oncol, 19, 492-6.   DOI
23 Sutton G, Kauderer J, Carson LF, et al (2005). Gynecologic Oncology Group. Adjuvant ifosfamide and cisplatin in patients with completely resected stage I or II carcinosarcomas (mixed mesodermal tumors) of the uterus: a Gynecologic Oncology Group study. Gynecol Oncol, 96, 630-4.   DOI
24 Tavassoli FA, Devilee P (2003). Pathology and Genetics of Tumors of the Breast and Female Genital Organs. World Health Organization Classification of Tumors. Lyon, France: IARC Pres
25 Temkin SM, Hellmann M, Lee YC, Abulafia O (2007). Earlystage carcinosarcoma of the uterus: the significance of lymph node count. Int J Gynecol Cancer, 17, 215-9.   DOI
26 Benito V, Lubrano A, Arencibia O, et al (2009). Clinicopathologic analysis of uterine sarcomas from a single institution in the Canary Islands. Int J of Gynecology & Obstetrics, 107,44-9.   DOI
27 Tsikouras P, Liberis V, Galazios G, et al (2008). Uterine sarcoma: a report of 57 cases over a16-year period analysis. Eur J Gynecol Oncol, 29, 129-34.
28 Van Nagell JR Jr, Hanson MB, Donaldson ES, Gallion HH (1986). Adjuvant vincristine, dactinomycin, and cyclophosphamide therapy in stage I uterine sarcomas. A pilot study. Cancer, 57, 1451-4.   DOI   ScienceOn
29 Wolfson AH, Wolfson DJ, Sittler SY, et al (1994). A multivariate analysis of clinicopathologic factors for predicting outcome in uterine sarcomas. Gynecol Oncol, 52, 56-62.   DOI   ScienceOn
30 Ali S, Wells M (1993). Mixed müllerian tumors of the uterine corpus: a review. Int J Gynecol Cancer, 3, 1-11.   DOI
31 Benoit L, Arnould L, Cheynel N, et al (2005). The role of surgery and treatment trends in uterine sarcoma. Eur J Surg Oncol, 31, 434-42.   DOI
32 Chavenic L, Deniaud E, Plancher C, et al (1999). Uterine sarcomas: The Curie Institute experience. Prognosis factors and adjuvant treatments. Gynecol Oncol, 72, 232-7.   DOI   ScienceOn
33 D'Angelo E, Prat J (2010). Uterine sarcomas: A review. Gynecol Oncol, 116, 131-9.   DOI
34 Echt G, Jepson J, Steel J, et al (1990). Treatment of uterine sarcomas. Cancer, 66, 35-9.   DOI   ScienceOn
35 Einstein MH, Klobocista M, Hou JY, et al (2012). Phase II trial of adjuvant pelvic radiation "sandwiched" between ifosfamide or ifosfamide plus cisplatin in women with uterine carcinosarcoma. Gynecol Oncol, 124, 26-30.   DOI   ScienceOn
36 El Husseiny G, Al Bareedy N, Mourad WA, et al (2002). Prognostic factors and treatment modalities in uterine sarcoma. Am J Clin Oncol, 25, 256-60.   DOI
37 Gaducci A, Cosio S, Romanini A, Genazzani AR (2008). The management of patients with uterine sarcoma: a debated clinical challenge. Crit Rev Oncol Hematol, 65, 129-42.   DOI   ScienceOn
38 George M, Pejovic MH, Kramar A (1986). Uterine sarcomas: prognostic factors and treatment modalities- study on 209 patients. Gynecol Oncol, 24, 58-67.   DOI
39 Ghaemmaghami F, Zarchi MK, Gilani MM, et al (2008). Uterine sarcoma: Clinicopathological characteristics, treatment and outcome in Iran. APJCP, 9, 421-6.