Article Text
Abstract
Introduction/Background Leiomyosarcoma is most common subtype among all uterine sarcoma. Aim of this study was to evaluate prognostic factors affecting oncologic outcome among patients of uterine leiomyosarcoma (uLMS).
Methodology This was a single institutional retrospective analysis of all patients who underwent treatment for uterine leiomyosarcoma from January 2005 till December 2017. Details of demographics, clinicopathological factors, Intraoperative finding and oncological outcome were obtained with the help of electronic medical records. Stage of disease was assessed as per International Federation of Obstetrics and Gynecologists (FIGO) 2009 classification for sarcoma. Overall survival (OS) and disease free Survival (DFS) was assessed and factors affecting survival were looked into. Chi square test or Fischer’s exact test were performed to compare categorical variable. Kaplan-Meier method was used to plot survival curves and to estimate time-to-event analyses.
Results From Jan 2005 to Dec 2017, 34 cases of uLMS were identified. Three cases excluded due to inadequate (<1 year) follow up details & total 31 cases included in the analysis. Median follow up period was 67.3 months. Median OS & PFS for whole study group was 30.2 (0–61) months and 20.3 (12–28.5) months respectively. Significant survival advantage were found for stage 1 in comparison with stage 2,3 & 4 (68.5 (37.5–99.4) months Vs 16.1(5.6–26.5) months, p≤0.001). Patients with intact uterus removal experienced an significant better OS of 68.5 (31.3–105) month while patients with intraoperative tumor rupture had OS of 12.4 (6.1–18.6) months (p=0.02). PFS >15 months was associated with significant better survival [68.5 (45–92) Vs 12.4 (10.6–14.2), p≤0.001]. We found more local recurrence in patients with intraoperative tumor capsule breech but was statistically insignificant.
Conclusion 5 years survival rate for uLMS was 31%. Stage 1, Intact uterus removal intraoperatively and PFS >15 months were favourable prognostic factors for long term survival in uLMS patients.
Disclosure Nothing to disclose.