Introduction/Background Adequate therapy of uterine leiomyosarcoma (LMS) is total hysterectomy. However, there is little information about the influence of bilateral salpingo-oophorectomy (BSO) on prognosis. This study analysed its influence on survival data.
Methodology Kaplan-Meier analysis and 5-year-overall survival probability depending on BSO and menopausal status in operated LMS.
Results From 294 patients with LMS 176 (59,9%) were postmenopausal. A BSO was performed additionally to total hysterectomy in 167 (56.8%) cases. In all patient‘s overall survival (OS) with BSO was shorter than in those without BSO but not statistically significant. Irrespectively of this procedure patients with BSO had primary a significantly worse 5-year-OS probability of 40 vs. 47 months (p≤0.01). In premenopause the OS was identical with and without BSO (figure 1). In postmenopause the OS was significantly worse with BSO (p≤0.046. (figure 2).
But, also irrespective from performed BSO the analysed OS is generally worse in postmenopausal vs. premenopausal patients. Additionally, the primary (!) 5-year-OS probabilitywas shorter than in premenopause (42 vs. 46 month). It also needs to be considered, that in postmenopause BSO was performed in 36% in stage pT2 and higher vs. 24% in premenopause. So, the worse OS in postmenopause depends not on BSO. In conclusion the preservation of ovaries in postmenopause does not improve prognosis.
Conclusion BSO does not influence prognosis in premenopausal patients. So, BSO in premenopause is not necessary if the ovaries are free of disease. In postmenopause the prognosis is generally worse than in premenopause and depends not on BSO.
Disclosure Nothing to disclose.
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