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645 Uterine sarcomas in young patients under 40 years of age: an epidemiological national-register-based retrospective cohort study
  1. Stoyan Georgiev Kostov1,2,
  2. Yavor Dimitrov Kornovski2,
  3. Stanislav Hristov Slavchev2,
  4. Yonka Ivanova Ivanova2,
  5. Dimitar Metodiev Mitkov3,4,
  6. Rafal Watrowski5,6,
  7. Ihsan Hasan Hasan7,
  8. Mariela Vasileva Slaveva1,8 and
  9. Angel Danchev Yordanov9
  1. 1Research Institute, Medical University Pleven, 5800, Pleven, Bulgaria
  2. 2Department of Gynecology, Hospital ‘Saint Anna’, Medical University—’Prof. Dr. Paraskev Stoyanov’, 9002, Varna, Bulgaria
  3. 3Clinical Pathology Laboratory, MHAT ‘Nadezda’ Women’s Health Hospital, 1373, Sofia, Bulgaria
  4. 4Neuropathological Laboratory, University Hospital ‘Saint Ivan Rilski’, 1431, Sofia, Bulgaria
  5. 5Department of Obstetrics and Gynecology, Helios Hospital Müllheim, 79379, Müllheim, Germany
  6. 6Faculty Associate, Medical Center, University of Freiburg, 79106, Freiburg, Germany
  7. 7Department of Obstetrics and Gynecology, University Hospital Sofiamed, Sofia, Bulgaria
  8. 8Department of Breast Surgery, Shterev Hospital, Sofia, Bulgaria
  9. 9Department of Gynecologic Oncology, Medical University Pleven, 5800, Pleven, Bulgaria


Introduction/Background Uterine sarcomas (USs) are rare malignant mesenchymal neoplasms, which represent 3–5 % of all malignancies of the uterine corpus. USs rarely affect women under 40 years of age. The study aims to investigate the incidence, clinical stage, and relevant pathological results of young women diagnosed with USs.

Methodology This is a national-register-based retrospective cohort study of patients with USs (≤ 40 years at diagnosis) registered at Bulgarian National Cancer Registry between 1993 and 2020. Carcinosarcomas were excluded as they represent metaplastic endometrial carcinomas.

Results Patients of all ages diagnosed with USs during the study period were 569, of which younger women (≤ 40 years at diagnosis) represented 55 patients(9.66%). 38 patients(69%) were diagnosed with uterine leiomyosarcoma(ULMS), 16 patients (29%) with endometrial stromal sarcoma (ESS), and one patient (2%) with undifferentiated uterine sarcoma. The median age of diagnosis of all patients was 35 years and 6 months (the younger patient – 18 years old with ULMS). The median age of diagnosis of ULMS and ESS were 35 years and 3 months, and 35 years and 7 months, respectively. The stage of the disease is known for 26 women with ULMS and 11 women with ESS. Eleven patients (42.3%) with ULMS were diagnosed at stage I of the disease and 10 patients (38.4%), 2 patients (7.6%), 3 patients (11.5%) with stage II, III and IV, respectively. For patients with ESS, 6 women (54.5%), 2 women (18.1%), and 3 women (27.2%) were diagnosed at stage I, II and III, respectively.

Conclusion Young patients with USs represent approximately 10% of patients of all ages diagnosed with uterine sarcoma. ULMS is the most commonly observed histology. Young patients with ULMS are mainly diagnosed at stages I and II of the disease. However, more than 10% of young patients with ULMS are diagnosed at stage IV.

Disclosures The authors have no relevant financial or non-financial interests to disclose.

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