Uterine sarcomas: An analysis of 69 patients

• Published in: International journal of radiation oncology, biology, physics Vol. 7; no. 7; pp. 917 - 922
• Main Authors: Mantravadi, Rao V.P., Bardawil, Wadi A., Lochman, David J., Liebner, Edwin J., Townsend, Darryl E.R., Chao, Jen Hung, Chaudhuri, Bina
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.01.1981
• Subjects: Combined treatment; Sites of failure; Uterine sarcoma; Uterine sarcoma; Sites of failure; Combined treatment
• DOI: 10.1016/0360-3016(81)90009-2
• ISSN: 0360-3016

Sixty-nine patients with a uterine sarcoma were reviewed in detail. The histological types included 32 leiomyosarcomas, 10 endometrial stromal sarcomas, 5 rhabdomyosarcomas, 14 mixed mesodermal sarcomas, and 3 fibrosarcomas. The type of sarcoma was not classified in 5 cases. Using International Federation of Gynecology & Obstetrics (FIGO) classification, 29 patients were categorized as Stage I, 5 as Stage II, 11 as Stage III, and 7 as Stage IV. Three percent of patients had a history of pelvic radiotherapy. In any given stage, patients with leiomyosarcoma had a better survival than other histologic types. Extent of disease at the diagnosis was directly related to the survival. Fifty-eight percent of patients with Stage I survived disease-free for 5 years, compared to 40% with Stage II and none with Stages III and IV. Despite the varied and individualized treatment policies adopted in these patients, comparable survival was noted in patients treated with surgery only and those with combined surgery and radiation. Fewer pelvic failures were seen in the combined treatment group. Sites of failure were analyzed in the 30 patients. Distant metastases occurred in 73.3% of the patients. Pulmonary metastases occurred in all the patients who failed with leiomyosarcoma and 53% of the patients with other tumor types. Hepatic metastases were second in frequency with non-leiomyosarcoma patients. Adjuvant postoperative radiotherapy is recommended for (greater than Stage I) leiomyosarcoma and for all patients with other tumor types. We suggest that systemic chemotherapy be incorporated in the comprehensive treatment of these tumors.