The role of surgery and treatment trends in uterine sarcoma

Aims. To report a series of uterine sarcomas treated in one institution. Methods. We report 72 cases of uterine sarcomas treated in a single institution, comparing the periods 1966-1989 and 1990-2001. The parameters studied were histological type, tumour stage and treatment. The control of pelvic, local and/or metastatic disease were also studied. Results. The histotogical. types consisted in 34 leiomyosarcomas, 25 mixte multerian tumours, 12 endometrial, stromal sarcoma and one angiosarcoma. The median age at diagnosis was 60.5 years. The presenting symptoms were genital bleeding, pelvic or abdominal pain. The proportion, of stage I was tower in 1966-1989 than in 1990-2002. During the 1966-1989 period, surgery was systematically used. The percentage of second-tine surgery (post- radiotherapy or -chemotherapy) rose from 2.2% in 1966-1989 to 19.2% in 1990-2002. Radiotherapy was administered in 55.5% of cases. There was no difference between the two periods. Chemotherapy was administered in 37.5% of cases with also no difference between the two periods. The overall. 2-year survival was 54.6% and the 5-year survival 36.1%. The median survival was 32.3 months (3 days-25 years). The overall 5-year survival, by stage was 47.5% for stage 1, 60.6% for stage II and 15.0% for stages III and IV. The median duration of pelvic disease control was 19.2 months. The 5-year pelvic disease control. by FIGO stage was 66.6% for stage I, 62.5% for stage II and 18% for the more advanced stages. Conclusion. Surgery remains the reference treatment. Local and regional disease control, as adjuvant therapies do not seem to decrease the risk of metastatic spread or increase survival. (c) 2005 Elsevier Ltd. All rights reserved.