Uterine sarcomas: review of 26 years at The Instituto Nacional de Cancerologia of Mexico

Int J Surg. 2013;11(7):518-23. doi: 10.1016/j.ijsu.2013.04.013. Epub 2013 May 7.

Abstract

Uterine sarcomas are a group of uncommon tumors that account for approximately 1% of malignant neoplasms of the female genital tract and between 3 and 8.4% of malignant uterine neoplasms.

Objective: To evaluate the factors associated with the clinical behavior of uterine sarcomas.

Materials and methods: In the period from October 1983 to December 2009, clinical files of patients with a confirmed diagnosis of uterine sarcoma at the National Institute of Cancerology of Mexico (INCan) were reviewed and evaluated.

Results: We identified 77 cases with complete information; average age at presentation was 51.6 years (range, 14-78 years); most frequent histology was leiomyosarcoma (LMS) in 53/77 (68.8%) cases; most frequent symptom reported at the time of diagnosis was abnormal vaginal bleeding in 36/77 (46.7%) cases, and the most frequent clinical stage was clinical stage (CS) I in 31/77 (40.2%) cases. Initial treatment was total abdominal hysterectomy (TAH) and bilateral salpingo-oophrectomy (BSO) in 53/77 (68.9%) cases. Disease-free period was 27.8 months (range, 0-184 months), with disease recurrence in 33/77 (42.85%) cases, most frequent site as lung in 13/33 (39.39%) cases. Management of recurrences was surgery and chemotherapy (CT) in 5/33 (15.15%) and CT in 10/33 (30.30%) of cases. At present, 40.3% of the patients (31/77) are found to be Disease-free.

Conclusion: Notwithstanding that uterine sarcomas are aggressive neoplasms, most accepted management to date is TAH + BSO, observing that the fact that this procedure is not performed by oncologists does not affect the DFP nor OS, contrary to what occurs in other gynecological neoplasms.

Keywords: Disease Free Survival; Sarcoma; Treatment; Uterine.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Disease-Free Survival
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Mexico
  • Middle Aged
  • Retrospective Studies
  • Sarcoma / diagnosis*
  • Sarcoma / drug therapy
  • Sarcoma / pathology
  • Uterine Neoplasms / diagnosis*
  • Uterine Neoplasms / drug therapy
  • Uterine Neoplasms / pathology