Introduction/Background Uterine sarcomas are an aggressive and rare entity, so uncertainty remains about their optimal management and prognostic factors.

The aim of this work is to study the cases of uterine sarcomas in a tertiary hospital, its diagnosis and treatment and to determine the influence of different variables on the survival and recurrence of these neoplasms.

Methodology We conducted a retrospective study including all patients diagnosed with uterine sarcoma between 2012 and 2022 (excluding carcinosarcoma) in a tertiary hospital in Madrid (Spain). A descriptive study is carried out and subsequently a survival analysis is performed in order to establish the prognostic factors.

Results A total of 24 cases of uterine sarcomas were studied. 13 patients (54.2%) were premenopausal and 11 (45.8%) postmenopausal. 9 cases (37.5%) presented as abnormal uterine bleeding, 5 (20.8%) postmenopausal bleeding, 3 (12.5%) constitutional syndrome, 1 (4.2%) coitorrhagia, 5 (20.8%) myoma growth, 1 (4.2%) pain. Transvaginal ultrasound was suspicious in 12 cases (50%). MRI was performed in 12 patients (50%), in 10 of which it was suspicious for malignancy. Three cases (12.5%) were inoperable. Hysterectomy with bilateral adnexectomy was performed in 17 cases (70.8%). In 3 cases (12.5%) pelvic exenteration was performed. In 1 case (4.2%) cervical amputation with bilateral adnexectomy was performed (previous subtotal hysterectomy for suspected myoma). The pathological anatomy was: 1 (4.2%) adenosarcoma, 1 (4.2%) fibrosarcoma, 17 (70.7%) leiomyosarcoma, 4 (16.7%) endometrial stromal sarcoma, 1 (4.2%) undifferentiated sarcoma. Median global survival was 4.73 years. The median disease-free interval was 3.5 years. None of the variables studied can be considered a predictor of overall survival or disease-free interval.

Conclusion Further studies with larger sample sizes are needed to determine the prognostic factors of uterine sarcomas in order to improve the diagnostic and therapeutic strategy for this group of aggressive gynaecological malignancies.

Disclosures There is no conflict of interest among the authors.