Article Text
Abstract
Introduction/Background The purpose of the study was to reveal clinical and morphological characteristics of patients with uterine sarcoma.
Methodology We studied case histories of 256 patients (24–72 years) with uterine sarcoma. Symptoms, characteristics of the disease stage and histostructure and sarcoma growth, the presence of concomitant diseases and the results of treatment were assessed.
Results The peak incidence was observed at 50–59 years of age (39.8%); 29.3% patients had stage I, 28.6% stage II, 22.6% stage III, 19.5% stage IV. 45% were diagnosed with leiomyosarcoma (LS), 36% endometrial stromal sarcoma (ESS), 19% carcinosarcoma (CS). Most patients were postmenopausal (71.3%). Most frequent gynecological diseases were hysteromyoma (47.5%) and endometrial polyposis (26.7%). Obesity was observed in 39.8%, hypertension in 32.8%; diabetes in 8.5% of patients. Pain in the lower abdomen was the main complaint reported by 63% of patients, bleeding from the genital tract was the second most common symptom (50.3%); the latter was most frequent in 60% patients with ESS. LS was most often located in the intramural myomatous nodule (50%). ESS showed a polypoidal growth pattern (76.4%); myometrial invasion of CS in 66.6% was >1 cm. Sarcomas were diagnosed by Doppler ultrasonography and dilation and curettage. 22.2% of patients were diagnosed using ultrasound. 5-year survival in patients with surgical treatment only (panhysterectomy) was ≤10% for all stages, in patients with combined treatment (surgery and external radiotherapy) - 49%, in patients with complex treatment (surgery, chemotherapy and external radiotherapy) - 65%.
Conclusion The disease peak occurred at 50–59 years of age (39.8%); early stages were diagnosed more often (57.9%). Pathognomonic symptoms were not observed. Histologically, LS (45%) and ESS (36%) prevailed. LS was most often located in the intramural myomatous nodule (50%). The best treatment outcomes were obtained in patients receiving complex treatment including surgical treatment, polychemotherapy and external radiotherapy.
Disclosure Nothing to disclose.