Article Text

Download PDFPDF
Prognostic factors in patients with uterine sarcoma: the SARCUT study
  1. Ignacio Zapardiel1,
  2. Myriam Gracia Segovia1,
  3. Ronalds Macuks2,
  4. Rosanna Mancari3,4,
  5. Patriciu Achimas-Cadariu5,
  6. Giacomo Corrado6,
  7. Arnoldas Bartusevicius7,
  8. Vladyslav Sukhin8,9,
  9. Juan C Muruzabal10,
  10. Pluvio J Coronado Martín11,
  11. Barbara Gardella12,
  12. Jurgen M Piek13,
  13. Nicole Concin14,15,
  14. Clemente Arab16,
  15. Dimitrios Papatheodorou17,
  16. Stephan Polterauer18,
  17. Sara Iacoponi1,
  18. Teresa Nieto19,
  19. Martha C Lopez-Sanclemente20,21,
  20. Hanna Trukhan22,
  21. Maria M Gil1,
  22. Irina Bakinovskaya22,
  23. Alena Dalamanava22,
  24. Marc Cucurull23,
  25. Dzmitry Rovski22,
  26. Laura Baquedano24,
  27. Luis Chiva25,
  28. Marcin Mardas26,
  29. Siarhei Anatolievich Mavrichev27,
  30. Jaroslav Klat28,
  31. Carlos A Lopez de la Manzanara29 and
  32. Yusuf Yildirim30
  33. on behalf of SARCUT Study Group
  1. 1Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain
  2. 2Riga East Clinical University Hospital Latvian Oncology Center, Riga, Latvia
  3. 3Gynecologic Oncology Department, IRCCS, Milan, Italy
  4. 4Gynecologic Oncology Department, IRCCS Regina Elena National Cancer Institute, Rome, Italy
  5. 5Gynecologic Oncology Department, The Oncology Institute ‘Prof Dr Ion Chiricuta’ Cluj-Napoca, Cluj-Napoca, Romania
  6. 6Policlinico Universitario Agostino Gemelli Dipartimento Scienze della Salute della Donna e del Bambino, Roma, Italy
  7. 7Department of Obstetrics and Gynaecology, Lithuanian University of Health Sciences, Kaunas, Lithuania
  8. 8Oncology, Radiology and Radiation Medicine, V N Karazin Kharkiv National University, Harkiv, Ukraine
  9. 9Oncogynecology, Grigoriev Institute for Medical Radiology NAMS of Ukraine, Harkiv, Ukraine
  10. 10Gynecologic Oncology Unit, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
  11. 11Gynecologic Oncology Unit, Hospital Clinico San Carlos, Madrid, Comunidad de Madrid, Spain
  12. 12Gynecologic Oncology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
  13. 13Gynecologic Oncology Department, Catharina Hospital and Catharina Cancer Institute, Eindhoven, Netherlands
  14. 14Department of Gynecology and Obstetrics, Innsbruck Medical Univeristy, Innsbruck, Austria
  15. 15Division of General Gynecology and Gynecologic Oncology, Department of Obstetrics and Gynecology, Gynecologic Cancer Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
  16. 16Gynecologic Oncology Department, Hospital Luis Tisné. Universidad de Chile, Santiago, Chile
  17. 17Gynecologic Oncology Department, Metaxa Memorial Cancer Hospital, Piraeus, Greece
  18. 18Karl Landsteiner Institute for General Gynecology and Experimental Gynecologic Oncology, Vienna, Austria
  19. 19Gynecologic Oncology Department, Hospital Universitario Santa Cristina, Madrid, Spain
  20. 20Gynecologic Oncology Department, Torrecárdenas Hospital Complex, Almeria, Andalucía, Spain
  21. 21Gynecologic Oncology Department, Clinica Diatros, Barcelona, Spain
  22. 22Gynecologic Oncology Department, N N Alexandrov National Cancer Center, Minsk, Belarus
  23. 23Catalan Institute of Oncology, L'Hospitalet de Llobregat, Catalunya, Spain
  24. 24Gynecologic Oncology Department, Hospital Universitario Miguel Servet, Zaragoza, Spain
  25. 25Obstetrics and Gynecology, Clinica Universidad de Navarra, Madrid, Spain
  26. 26Department of Gynecological Oncology, Poznan University of Medical Sciences, Poznan, Wielkopolskie, Poland
  27. 27Gynecological Oncology, N N Alexandrov National Cancer Center, Minsk, Belarus
  28. 28Obstetrics and Gynecology Department, University Hospital Ostrava, Ostrava, Moravskoslezský, Czech Republic
  29. 29Gynecologic Oncology Department, Hospital General Universitario de Ciudad Real, Ciudad Real, Castilla-La Mancha, Spain
  30. 30Gynecologic Oncology Department, Tepecik Training and Research Hospital Clinics, Konak, Izmir, Turkey
  1. Correspondence to Dr Ignacio Zapardiel, Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain; ignaciozapardiel{at}hotmail.com

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.

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

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.

View Full Text

Footnotes

  • Twitter @marthalo90

  • 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.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.