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Abstract
Objective Uterine sarcomas are a rare and heterogeneous group of malignancies that include different histological sub-types. The aim of this study was to identify and evaluate the impact of the different prognostic factors on overall survival and disease-free survival of patients with uterine sarcoma.
Methods This international multicenter retrospective study included 683 patients diagnosed with uterine sarcoma at 46 different institutions between January 2001 and December 2007.
Results The 5-year overall survival for leiomyosarcoma, endometrial stromal sarcoma, undifferentiated sarcoma, and adenosarcoma was 65.3%, 78.3%, 52.4%, and 89.5%, respectively, and the 5-year disease-free survival was 54.3%, 68.1%, 40.3%, and 85.3%, respectively. The 10-year overall survival for leiomyosarcoma, endometrial stromal sarcoma, undifferentiated sarcoma and adenosarcoma was 52.6%, 64.8%, 52.4%, and 79.5%, respectively, and the 10-year disease-free survival was 44.7%, 53.3%, 40.3%, and 77.5%, respectively. The most significant factor associated with overall survival in all types of sarcoma except for adenosarcoma was the presence of residual disease after primary treatment. In adenosarcoma, disease stage at diagnosis was the most important factor (hazard ratio 17.7; 95% CI 2.86 to 109.93).
Conclusion Incomplete cytoreduction, tumor persistence, advanced stage, extra-uterine and tumor margin involvement, and the presence of necrosis were relevant prognostic factors significantly affecting overall survival in uterine sarcoma. The presence of lymph vascular space involvement and administration of adjuvant chemotherapy were significantly associated with a higher risk of relapse.
- uterine cancer
- sarcoma
Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information. In accordance with the journal guidelines, we will provide our data for independent analysis by a selected team by the Editorial Team for the purposes of additional data analysis or for the reproducibility of this study in other centers if such is requested.
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Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information. In accordance with the journal guidelines, we will provide our data for independent analysis by a selected team by the Editorial Team for the purposes of additional data analysis or for the reproducibility of this study in other centers if such is requested.
Footnotes
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Collaborators SARCUT Study Group: P Achimas-Cadariu, The Oncology Institute 'Prof Dr Ion Chiricuta' Cluj-Napoca, Romania. MS Aniorte Martínez, Hospital General Universitario de Valencia, Spain. C Arab Eblen, Hospital Luis Tisné, Universidad de Chile, Chile. I Bakinovskaya, N N Alexandrov National Cancer Center of Belarus, Belarus. L Baquedano, Hospital Universitario Miguel Servet, Spain. A Bartusevicius, Lithuanian University of Health Sciences, Lithuania. C Bhugwandass, Comprehensive Cancer Center South location TweeSteden Hospital, The Netherlands. L Chiva, MD Anderson España, Spain. N Concin, Department of Gynecology and Obstetrics, Medical University of Innsbruck, Austria. PJ Coronado Martín, Hospital Clínico San Carlos, Spain. G Corrado, Department of Experimental Clinical Oncology, Gynecologic Oncology Unit, IRCCS "Regina Elena" National Cancer Institute; and Department of Woman, Child Health and Public Health, Gynecologic Oncology Unit, A Gemelli University Hospital Foundation, IRCSC, Rome, Italy. L Cusiné López, Hospital Igualada, Spain. A Dalamanava, N N Alexandrov National Cancer Center of Belarus, Belarus. K Dallaku, Obstetric Gynecology University Hospital Koco Gliozheni, Tirana, Albania. N Dubois, Hopital Saint Jean Bruxelles, Belgium. V Fernández González, Complejo Asistencial Universitario de León, Spain. B Gardella, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. M del M Gil Mira, La Paz University Hospital, Spain. M Gracia, La Paz University Hospital, Spain. E Gonçalves, Unidade Local de Saúde de Portugal. AG Heredia Caballero, Clinica de Especialidades de la Mujer, Mexico. S Iacoponi, La Paz University Hospital, Spain. J Klat, Ob/Gyn. Dept. University Hospital Ostrava, Czech Republic. E Lambaudie, Paoli Calmettes institute, France. CA López de la Manzanara Cano, Hospital General Universitario de Ciudad Real, Spain. MC López Sanclemente, Hospital Torrecárdenas and Clínica Diatros, Spain. R Macuks, Latvian Oncology Center of Riga Eastern Clinical University Hospital, Latvia. TK Madhuri, Royal Surrey County Hospital NHS Foundation Trust, UK. MR Mallmann, Department of Obstetrics, Division of Gynecologic Oncolgy. European Institute of Oncology, IRCCS, Milan, Italy. M Marcin, Department of Oncology, Poznan University of Medical Sciences, Poland. A Martinez Garrido, Xarxa Sanitaria i Social de Santa Tecla, Spain. S Mavrichev, N N Alexandrov National Cancer Center of Belarus, Belarus. M Mitidieri, OIRM Sant Anna, Italy. I Mitsakis, Theagenio Anticancer Hospital of Thessaloniki, Greece. JC Muruzabal, Complejo Hospitalario de Navarra, Spain. T Nieto, Santa Cristina University Hospital, Spain. Z Novak, Dept of Gynecologic Oncology, St Stephen’s Hospital, Hungary. E Ortega, Hospital Arnau de Vilanova, Lleida, Spain. D Papatheodorou, Metaxa Memorial Cancer Hospital, Greece. J Piek, Catharina Hospital and Catharina Cancer Institute, The Netherlands. A Pletnev, N N Alexandrov National Cancer Center of Belarus, Belarus. S Polterauer, Comprehensive Cancer Center Vienna, Medical University of Vienna, Austria. M Romeo, ICO Badalona, Spain. G Roviglione, Sacred Heart Hospital – Negrar, Italy. D Rovski, N N Alexandrova National Cancer Center of Belarus, Belarus. R Sequeira Campos, Hospital Pedro Hispano, Portugal. V Sukhin, Grigoriev Institute for Medical Radiology and Oncology, Nams, Ukraine. H Trukhan, N N Alexandrov National Cancer Center of Belarus, Belarus. Y Yildirim, Tepecik Training and Research Hospital, Turkey. I Zapardiel, La Paz University Hospital, Spain. O Zivanovic, University Hospital of Bonn, Germany.
Contributors All 32 authors contributed to the study design, data acquisition, and/or interpretation of the data, and all reviewed and approved the final version of the manuscript. All authors are accountable for all aspects of this work. In addition, the rest of collaborators participated by collecting data from their institutions. IZ will be the the author acting as guarantor.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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