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447 Prognostic factors related to uterine sarcoma
  1. D González García-Cano,
  2. AF Rave Ramirez,
  3. M Armas Roca,
  4. M Laseca Modrego,
  5. O Arencibia Sanchez,
  6. A Martín Martínez and
  7. T Benitez Delgado
  1. Complejo Hospitalario Universitario Insular Materno Infantil de Gran Canaria , Gynecologic Oncology, las palmas de gran canaria, Spain


Introduction/Background*The objective of this study was to analyze prognostic factors related to uterine sarcoma.

Methodology Retrospective observational cohort study conducted at the CHUIMI in the canary islands from 01/01/2009 to 12/31/2018. We included all patients with a diagnosis of uterine sarcoma (n: 46).Variables analyzed in the study were age and BMI at diagnosis,histology,staging,if Morcellation and/or tumor fragmentation ocurred,if free margins were obtained in the surgery and lymph node involvement. The Statistical analysis was performed with SPSS for Mac version 20.0. A description of the main variables included was made. In addition, we ran a multivariate analysis through linear regression, using the Enter method, with the objective of analyze the prognostic factors associated with the presence of uterine sarcoma. The calculation of the magnitude of association was made using the OR and its corresponding confidence interval at the 95% (95% CI). In all hypothesis tests, a significance level of 0.05 was considered.

Result(s)*The incidence of uterine sarcoma in our setting was 5.35% (total uterine cancer: 859). The mean age was (53.5 ± 10.9) and the BMI (29.9 ± 9.1). There were 30 leiomyosarcomas (63.8%), 16 endometrial stromal sarcomas (34%) and a high-grade adenosarcoma (2.1%). If we look at the staging, IA (14 (29.8%)); IB (13 (27.7,%)); IIA (1 (2.1%)); IIB (3 (6.4%)), there was no case of IIIA; IIIB (2 (4.3%)); IIIC (2 (4.3%)); IV A (2 (4.3%)) and IV B (10 (21.3%)). In multivariate analysis using logistic regression, leaving free margins in the piece, acts as a protective factor (OR -2.13; CI 95% 0.02-0.6 (p value 0.01)). Having lymph node involvement does not behave as a prognostic factor in this study and the morcellation and/or fragmentation variable was eliminated from the study after a fitted model.

Conclusion*For tumors limited to uterus, the prognostic factors described are: tumor size, mitotic index, tumor necrosis, vascular invasion, free surgical margins and morcellation. In our sample and according to what has been published, we can conclude that the surgery will determine the prognosis. Being fundamental keep margins free on the piece to improve prognosis.

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