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

• Published in: International journal of surgery (London, England) Vol. 11; no. 7; pp. 518 - 523
• Main Authors: Cantú de León, David, González, Heliodoro, Pérez Montiel, Delia, Coronel, Jaime, Pérez-Plasencia, Carlos, Villavicencio-Valencia, Verónica, Soto-Reyes, Ernesto, Herrera, Luis Alonso
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.01.2013
• Subjects: Adolescent; Adult; Aged; Disease Free Survival; Female; Humans; Kaplan-Meier Estimate; Mexico; Middle Aged; Retrospective Studies; Sarcoma; Sarcoma - diagnosis; Sarcoma - drug therapy; Sarcoma - pathology; Surgery; Treatment; Uterine; Uterine Neoplasms - diagnosis; Uterine Neoplasms - drug therapy; Uterine Neoplasms - pathology; Mexico; Treatment; Disease Free Survival; Sarcoma; Uterine
• ISSN: 1743-9191; 1743-9159
• DOI: 10.1016/j.ijsu.2013.04.013

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.