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Wilms Tumor Gene 1 (WT1) is a Prognostic Marker in High-Grade Uterine Sarcoma
  1. An Coosemans, MD*,,,
  2. Ben Van Calster, PhD§,
  3. Godelieve Verbist*,
  4. Philippe Moerman, MD, PhD,
  5. Ignace Vergote, MD, PhD*,,
  6. Stefaan W. Van Gool, MD, PhD, and
  7. Frédéric Amant, MD, PhD*,
  1. * Laboratory of Experimental Gynecology,
  2. Laboratory of Experimental Immunology, Departments of
  3. Child and Women,
  4. § Electrical Engineering (ESAT), and
  5. Human Pathology, UZ Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium.
  1. Address correspondence and reprint requests to Frédéric Amant, MD, PhD, Department of Gynaecologic Oncology, University Hospital Leuven, Herestraat 49, 3000 Leuven, Belgium. E-mail: frederic.amant{at}


Introduction: Wilms tumor gene 1 (WT1) contributes to uterine sarcoma tumor biology. In this study, we aimed to clarify the prognostic value of WT1.

Methods: A retrospective clinical and histopathological review of 71 women with high-grade uterine sarcoma (leiomyosarcoma [n = 24], undifferentiated sarcoma [n = 9]), and carcinosarcoma (n = 38) was performed. Patients were followed up for at least 12 months. Wilms tumor gene 1 expression was determined by immunohistochemistry. Data on recurrence (progression-free survival) and overall survival (OS) were available for all patients. Univariate and multivariate analyses of WT1 expression were carried out using Kaplan-Meier curves and Cox regression, respectively.

Results: Forty-nine (69%) tumors were WT1 positive. Forty-seven (66%) patients died of the disease, with a median OS time of 22 months. Wilms tumor gene 1 was a predictor of survival in the univariate analysis: the hazard ratio of WT1 positivity was 2.44 (95% confidence interval, 1.34-4.71) for progression-free survival and 2.48 (95% confidence interval, 1.26-4.90) for OS. Multivariate analysis including stage, age, tumor size, and sarcoma subtype identified only stage and WT1 positivity as independent prognostic markers for survival.

Conclusions: The identification of WT1 as a prognostic marker confirms its role in high-grade uterine sarcoma and carcinosarcoma tumor biology.

  • Wilms tumor gene 1
  • WT1
  • Uterine sarcoma
  • Prognosis

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  • The authors declare that there are no conflicts of interest.