Clinical outcome and prognostic factors in 100 cases of uterine sarcoma: Experience in Helsinki University Central Hospital 1990-2001

Objective. Uterine sarcomas are rare malignant gynecological tumors with poor prognosis. In this study clinical data on all uterine sarcoma patients treated at Helsinki University Central Hospital (HUCH) between 1990-2001 were retrospectively evaluated. Methods. Medical records were reviewed and data collected on all uterine sarcomas treated during a 12-year period at HUCH. Kaplan-Meier survival curves were generated and those variables found to be statistically significant in univariate analysis were examined by multivariate analysis using Cox's proportional hazards regression model. Results. One hundred patients met the study requirements: 40 cases were diagnosed as carcinosarcomas, 39 as leiomyosarcomas and 21 as endometrial stromal sarcomas. First-line treatment was Surgery in 98% of the patients. Seventy-eight of the patients were treated by means of adjuvant therapy. A complete response was achieved in 80% and a partial response in 4% of the cases. The 2-, 5- and 10-year overall survival rates were 62%, 51% and 38% and disease-specific survival rates were 64%, 56% and 44% (all sarcomas). In multivariate analysis, stage, age, tumor size and parity were proven to have independent influences on overall survival, and stage, tumor size and parity also independently influenced disease-specific survival. Conclusions. In this study, survival rates were better than in nearly all previous retrospective studies of uterine sarcomas. It seems that higher parity could have a negative influence on survival in cases of uterine sarcoma. (C) 2008 Elsevier Inc. All rights reserved.