Article Text
Abstract
Introduction/Background Uterine sarcomas are rare aggressive gynecologic malignancies that are characterized by a high rate of recurrence with poor prognosis. This study aimed to analyze the clinicopathological features and explore different prognostic factors affecting clinical outcomes of locally advanced uterine sarcomas.
Methodology This is a retrospective cohort study for patients recorded at a single institutional GYN oncology unit from 2018 to 2022 and confirmed with histopathological examination to be uterine sarcomas.
All cases were subjected to radiological staging to exclude metastatic disease then surgical treatment through laparotomy for hysterectomy and bilateral salpingo-oophorectomy with excision of any suspected pelvic extension. Thereafter, adjuvant therapy (Radiotherapy, and or chemotherapy) or observation was considered according to the stage of patients. The correlation between clinicopathological factors and clinical outcomes either overall survival (OS) and progression-free survival (PFS) was analyzed using multivariate analysis modules.
Results A total number of 38 cases underwent surgical treatment through laparotomy for hysterectomy and bilateral salpingo-oophorectomy. The most commonly recorded subtype was uterine leiomyosarcoma ULMS, (19/38), then high-grade endometrial stromal sarcoma HGESS (7/38), adenosarcoma AS (6/38), while undifferentiated uterine sarcoma UUS and low-grade endometrial stromal sarcoma LG ESS account for the least percentage, (4/38, 2/38) respectively.
The overall median survival time was 36 months. Uterine sarcomas with FIGO stage I, had a longer OS in comparison to cases with higher stages, (P= 0.04).
Multivariant regression analysis for the histopathology subtype, age, tumor size, and FIGO stage were considered independent factors for the prediction of OS and PFS. Results showed that the tumor size was the strongest independent prognostic factor for the OS, P=0.032, and PFS, P= 0.022.
Conclusion In uterine sarcoma, a higher FIGO stage is associated with lower OS. In addition, tumor size is considered a poor prognostic factor for decreased both OS and PFS.
Disclosures The authors declare no conflict of interest. This research received no external funding.
The datasets used in the current study are available from the corresponding author upon reasonable request.