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Abstract
Introduction/Background Uterine sarcomas are rare diseases with no specific characteristics on imaging, so preoperative diagnosis remains challenging. The diagnostics is usually performed before treatment of what is supposed to be a benign tumour and, therefore, not at referral centres.
Methodology We performed a retrospective study of patients with uterine sarcoma treated at our centre between 2012 and 2022. We aimed to analyse the preoperative management and clinical characteristics of the tumours, and to propose appropriate clinical pathways for these patients in small countries with a low number of inhabitants.
Results We identified 21 women with an average age of 59±11 years. The most common clinical symptom was vaginal bleeding (61.9% of patients). Uterine sarcoma was confirmed in 42.9% of patients before primary surgery. Tumours were classified as leiomyosarcomas (38.1%), low-grade endometrial stromal sarcomas (ESS) (23.8%), high-grade or undifferentiated ESS (19%), liposarcomas (4.8%), and as adenosarcomas (14.3%). 81% of patients were operated as having uterine tumour, of which 14.3% had either enucleation or morcellation of the tumour/uterus due to presumed uterine fibroma. 33.3% of all patients had a primary metastatic disease when presented at our centre, and 28.6% had a recurrent disease. In patients with a follow-up period of 5 years or more, the OS was 46.2% (figure 1).
Conclusion Our results confirmed that the clinical and histopathological characteristics of uterine sarcomas are very diverse. As their incidence is extremely rare when compared to benign fibroids, the main challenge remains in defining the criteria to select which patients should be referred for further diagnostics and treatment to tertiary centres before surgical procedure. Specifically in small countries, an additional challenge is the fact that even a single referral centre is still a low volume centre.
Disclosures No conflicts of interest.
