Klinik Araştırma
BibTex RIS Kaynak Göster

Prognostic and Predictive Factors for Uterine Sarcomas: A Single Center Experience

Yıl 2025, Cilt: 35 Sayı: 1, 7 - 15, 28.02.2025
https://doi.org/10.54005/geneltip.1430965

Öz

Objective: To determine the factors impacting recurrence and long-term survival in uterine sarcoma patients, recognizing the challenge due to histological diversity and lack of definitive treatment.
Methods: We reviewed data from uterine sarcoma patients treated from July 2010 to August 2021. Cases were divided into endometrial stromal sarcoma (ESS), leiomyosarcoma (LMS), and others (rhabdomyosarcoma, adenosarcoma), examining clinicopathological features, age, survival rates, and recurrence risk factors.
Results: In 43 patients (average age 59.1), most common symptom was vaginal bleeding. Majority were postmenopausal, with a breakdown of 65.1% ESS, 18.6% LMS, and 16.3% other sarcomas. Most (65.1%) were stage 1. Surgery was primarily via laparotomy (95.3%), with 79.1% receiving adjuvant therapy. Recurrence was 18.6%. Significant differences in survival rates were found across groups, with LMS significantly affecting survival and recurrence risk linked to tumor size and surgical stage. Five-year overall survival was 72.1%, and disease-free survival was 67.4%.
Conclusion: ESS is the most common uterine sarcoma, but LMS presents the worst prognosis. Tumor size and surgical stage are key to recurrence risk, highlighting the need for further study on adjuvant treatments.

Etik Beyan

2022/404 sayılı kararı selcuk üniversitesi tıp fakültesi etik kurulu

Destekleyen Kurum

yok

Teşekkür

no conflict of interest

Kaynakça

  • 1. D’Angelo E, Prat J. Uterine sarcomas: a review. Gynecol Oncol 2010; 116: 131-139.
  • 2. Bocker W. [WHO classification of breast tumors and tumors of the female genital organs: pathology and genetics]. Verh Dtsch Ges Pathol 2002; 86: 116-119.
  • 3. FIGO Committee on Gynecologic Oncology. FIGO staging for uterine Sarcomas. Int. J. Gynecol. Obstet. 2009, 179, Corrigendum in Int. J. Gynecol. Obstet. 2009, 106, 277.
  • 4. Benson C, Miah AB (2017) Uterine sarcoma—current perspectives. Int J Womens Health 9:597–606.
  • 5. Shushkevich AT, P.H.; Littell, R.D.; Shah, N.A.; Chiang, S.; Thornton, K.; Hensley, M.L.; Slomovitz, B.M.; Holcomb, K.M.; Leitao, M.M.; et al. State of the science: Uterine sarcomas: From pathology to practice. Gynecol. Oncol. 2020, 159, 3–7.
  • 6. Cantú de León DG, H.; Pérez Montiel, D.; Coronel, J.; Pérez-Plasencia, C.; Villavicencio-Valencia, V.; Soto-Reyes, E.; Herrera, L.A. Uterine sarcomas: Review of 26 years at The Instituto Nacional de Cancerologia of Mexico. Int. J. Surg. 2013, 11, 518–523.
  • 7. Burghaus SH, S.; Gass, P.; Mehlhorn, G.; Schrauder, M.G.; Lux, M.P.; Renner, S.P.; Beckmann, M.W.; Hein, A.; Thiel, F.C. Outcome and prognosis in uterine sarcoma and malignant mixed Mullerian tumor. Arch. Gynecol. Obstet. 2016, 294, 343–351.
  • 8. Kyriazoglou AL, M.; Ziogas, D.C.; Zagouri, F.; Koutsoukos, K.; Tsironis, G.; Tsiara, A.; Kaparelou, M.; Zakopoulou, R.; Thomakos, N.; et al. Management of uterine sarcomas and prognostic indicators: Real-world data from a single institution. BMC, Cancer 2018, 1247.
  • 9. Wickerham DL FB, Wolmark N, Bryant J, Costantino J, Bernstein L, Runowicz CD. Association of tamoxifen and uterine sarcoma. J Clin Oncol 2002; 20: 2758-2760.
  • 10. Chu CS LL, Rubin SC. Cancer of the uterine body. DeVita, Hellman, and Rosenberg's Cancer: Principles & Practice of Oncology. 8th ed. DeVita VT, Lawrence TS, Rosenberg SA, editors. Philadelphia: WoltersKluwer/Lippincott Williams &Wilkins; 2008. pp 1543-1563.
  • 11. Sagae S YK, Ishioka S, et al. Preoperative diagnosis and treatment results in 106 patients with uterine sarcoma in Hokkaido, Japan. Oncology 2004;67:33-39.
  • 12. Gadducci A CS, Romanini A, Genazzani AR. The management of patients with uterine sarcoma: a debated clinical challenge. Crit Rev Oncol Hematol 2008;65:129-142.
  • 13. Akahira J TH, Toyoshima M, Takano T, Nagase S, Yoshinaga K, Tase T, Wada Y, Ito K, Niikura H, Yamada H, Sato A, Sasano H, Yaegashi N. Prognoses and prognostic factors of carcinosarcoma, endometrial stromal sarcoma and uterine leiomyosarcoma: a comparison with uterine endometrial adenocarcinoma. Oncology 2006; 71: 333-340.
  • 14. Chauveinc L DE, Plancher C, et al. Uterine sarcomas: the Curie Institute experience. Prognosis factors and adjuvant treatments. Gynecol Oncol 1999;72:232-237.
  • 15. Eiriz IV, M.; Gomes, F.; Braga, S. Uterine Sarcomas: A Retrospective Analysis of a Cohort of 62 Patients. Cureus 2021, 13, e13349.
  • 16. Ruiz-Minaya M M-VE, Vasquez-Jimenez W, Perez-Burrel L, Aracil-Moreno I, Agra-Pujol C, Bernal-Claverol M, Martínez-Bernal BL, Muñoz-Fernández M, Morote-Gonzalez M, Ortega MA, Lizarraga-Bonelli S, De Leon-Luis JA. Retrospective Analysis of Patients with Gynaecological Uterine Sarcomas in a Tertiary Hospital. J Pers Med. 2022 Feb 6;12(2):222.
  • 17. Oliva E CM, Carinelli SG, et al. Mesenchymal Tumors of the Uterus. In: Kurman RJ, Carcangiu ML, Herrington CS, Young RH, eds. WHO Classification of Tumours of Female Reproductive Organs. 4th ed. Lyon, France: IARC Press, 2014. 135-147.
  • 18. Amin MB ES, Greene FL, et al, eds. AJCC Cancer Staging Manual. 8th ed. New York: Springer; 2017.
  • 19. Kostov S KY, Ivanova V, Dzhenkov D, Metodiev D, Watrowski R, Ivanova Y, Slavchev S, Mitev D, Yordanov A. New Aspects of Sarcomas of Uterine Corpus - A Brief Narrative Review. Clin Pract. 2021 Nov 22;11(4):878-900. doi: 10.3390/clinpract11040103.
  • 20. Suchetha S VT, Rema P, Sivaranjith J, Kumar A, Krishna KMJ, James FV. Uterine Sarcoma: Retrospective Study From A Single Institute. J Obstet Gynaecol India. 2022 Aug;72(Suppl 1):306-312. doi: 10.1007/s13224-021-01612-9.
  • 21. Sait HKA, N.M.; El Sayed, M.E.; Alkhayyat, S.S.; Ghanem, A.T.; Abayazid, R.M.; Sait, K.H. Uterine sarcoma. Clinicopathological characteristics and outcome. Saudi Med. J. 2014, 35, 1215–1222.
  • 22. Wang F DX, Chen H, Hu X, Wang Y. Clinical characteristics and prognosis analysis of uterine sarcoma: a single-institution retrospective study. BMC Cancer. 2022 Oct 7;22(1):1050. doi: 10.1186/s12885-022-10129-x.
  • 23. Gao Y, Meng H, Zhang Y, Jiao T, Hui N. Retrospective analysis of 80 cases with uterine carcinosarcoma, leiomyosarcoma and endometrial stromal sarcoma in China, 1988-2007. Int J Clin Exp Pathol. 2014 Mar 15;7(4):1616-24.
  • 24. Nano, O.; Nieto, M.J.; Saif, M.W.; Tarabichi, M. Retrospective Analysis of Patients with Gynecological Uterine Sarcomas: Leiomyosarcomas and other Histological Subtypes at a Single Institution from 1996 to 2015. Cancer Med. J. 2020, 3, 30–37.
  • 25. Ronsini C FA, Giudice M, Reino A, La Verde M, Della Corte L, Bifulco G, Franciscis P, Cianci S, Capozzi VA. Is Adnexectomy Mandatory at the Time of Hysterectomy for Uterine Sarcomas? A Systematic Review and Meta-Analysis. Medicina (Kaunas). 2022 Aug 23;58(9):1140. doi: 10.3390/medicina58091140.
  • 26. Reed NS MC, Malmströ m H, et al. Phase III randomized study to evaluate the role of adjuvant pelvic radiotherapy in the treatment of uterine sarcomas stages I and II: A European Organisation for Research and Treatment of Cancer Gynaecological Cancer Group Study (protocol 55874). Eur J Cancer 2008;44:808-818.
  • 27. Nam JH. Surgical treatment of uterine sarcoma. Best Pract Res Clin Obstet Gynaecol 2011;25:751-760.
  • 28. Barquet-Muñoz, S.A.; Isla-Ortiz, D.; Montalvo-Esquivel, G.; Cantú-de-León, D.; Salcedo-Hernández, R.A.; Cordoba-Gonzalez, V.; Herrera-Gómez, Á. Prognostic factors associated with uterine sarcomas: The experience of a single institution. J. Obstet. Gynaecol. 2019, 39, 231–236.
  • 29. Li D YN, Du G, Wang S, Xiao Z, Chen J, Chen W. A Real-World Study on Diagnosis and Treatment of Uterine Sarcoma in Western China. Int J Biol Sci. 2020 Jan 1;16(3):388-395. doi: 10.7150/ijbs.39773.
  • 30. Wang LL, S.; Zhang, Z.; Jia, J.; Shan, B. Prevalence and occult rates of uterine leiomyosarcoma. Medicine 2020, 9, e21766.
  • 31. Nordal RN KK, Stenwig AE, Tropé CG. Leiomyosarcoma (LMS) and endometrial stromal sarcoma (ESS) of the uterus. A survey of patients treated in the Norwegian Radium Hospital 1976 - 1985. Int J Gynecol Cancer 1993;3:110-115.
  • 32. Coussens LM, Werb Z. Inflammation and cancer. Nature. 2002 Dec 19-26;420(6917):860-7. doi: 10.1038/nature01322.
  • 33. Szkandera J AG, Liegl-Atzwanger B, Pichler M, Stotz M, Samonigg H, Glehr M, Zacherl M, Stojakovic T, Gerger A, Leithner A. Elevated preoperative neutrophil/lymphocyte ratio is associated with poor prognosis in soft-tissue sarcoma patients. Br J Cancer. 2013 Apr 30;108(8):1677-83. doi: 10.1038/bjc.2013.135.
  • 34. Jeong MJ PJ, Hur SY, Kim CJ, Nam HS, Lee YS. Preoperative Neutrophil-to-Lymphocyte Ratio as a Prognostic Factor in Uterine Sarcoma. J Clin Med. 2020 Sep 8;9(9):2898. doi: 10.3390/jcm9092898.

Uterus Sarkomlarında Prognostik ve Prediktif Faktörler: Tek Merkez Deneyimi

Yıl 2025, Cilt: 35 Sayı: 1, 7 - 15, 28.02.2025
https://doi.org/10.54005/geneltip.1430965

Öz

Kaynakça

  • 1. D’Angelo E, Prat J. Uterine sarcomas: a review. Gynecol Oncol 2010; 116: 131-139.
  • 2. Bocker W. [WHO classification of breast tumors and tumors of the female genital organs: pathology and genetics]. Verh Dtsch Ges Pathol 2002; 86: 116-119.
  • 3. FIGO Committee on Gynecologic Oncology. FIGO staging for uterine Sarcomas. Int. J. Gynecol. Obstet. 2009, 179, Corrigendum in Int. J. Gynecol. Obstet. 2009, 106, 277.
  • 4. Benson C, Miah AB (2017) Uterine sarcoma—current perspectives. Int J Womens Health 9:597–606.
  • 5. Shushkevich AT, P.H.; Littell, R.D.; Shah, N.A.; Chiang, S.; Thornton, K.; Hensley, M.L.; Slomovitz, B.M.; Holcomb, K.M.; Leitao, M.M.; et al. State of the science: Uterine sarcomas: From pathology to practice. Gynecol. Oncol. 2020, 159, 3–7.
  • 6. Cantú de León DG, H.; Pérez Montiel, D.; Coronel, J.; Pérez-Plasencia, C.; Villavicencio-Valencia, V.; Soto-Reyes, E.; Herrera, L.A. Uterine sarcomas: Review of 26 years at The Instituto Nacional de Cancerologia of Mexico. Int. J. Surg. 2013, 11, 518–523.
  • 7. Burghaus SH, S.; Gass, P.; Mehlhorn, G.; Schrauder, M.G.; Lux, M.P.; Renner, S.P.; Beckmann, M.W.; Hein, A.; Thiel, F.C. Outcome and prognosis in uterine sarcoma and malignant mixed Mullerian tumor. Arch. Gynecol. Obstet. 2016, 294, 343–351.
  • 8. Kyriazoglou AL, M.; Ziogas, D.C.; Zagouri, F.; Koutsoukos, K.; Tsironis, G.; Tsiara, A.; Kaparelou, M.; Zakopoulou, R.; Thomakos, N.; et al. Management of uterine sarcomas and prognostic indicators: Real-world data from a single institution. BMC, Cancer 2018, 1247.
  • 9. Wickerham DL FB, Wolmark N, Bryant J, Costantino J, Bernstein L, Runowicz CD. Association of tamoxifen and uterine sarcoma. J Clin Oncol 2002; 20: 2758-2760.
  • 10. Chu CS LL, Rubin SC. Cancer of the uterine body. DeVita, Hellman, and Rosenberg's Cancer: Principles & Practice of Oncology. 8th ed. DeVita VT, Lawrence TS, Rosenberg SA, editors. Philadelphia: WoltersKluwer/Lippincott Williams &Wilkins; 2008. pp 1543-1563.
  • 11. Sagae S YK, Ishioka S, et al. Preoperative diagnosis and treatment results in 106 patients with uterine sarcoma in Hokkaido, Japan. Oncology 2004;67:33-39.
  • 12. Gadducci A CS, Romanini A, Genazzani AR. The management of patients with uterine sarcoma: a debated clinical challenge. Crit Rev Oncol Hematol 2008;65:129-142.
  • 13. Akahira J TH, Toyoshima M, Takano T, Nagase S, Yoshinaga K, Tase T, Wada Y, Ito K, Niikura H, Yamada H, Sato A, Sasano H, Yaegashi N. Prognoses and prognostic factors of carcinosarcoma, endometrial stromal sarcoma and uterine leiomyosarcoma: a comparison with uterine endometrial adenocarcinoma. Oncology 2006; 71: 333-340.
  • 14. Chauveinc L DE, Plancher C, et al. Uterine sarcomas: the Curie Institute experience. Prognosis factors and adjuvant treatments. Gynecol Oncol 1999;72:232-237.
  • 15. Eiriz IV, M.; Gomes, F.; Braga, S. Uterine Sarcomas: A Retrospective Analysis of a Cohort of 62 Patients. Cureus 2021, 13, e13349.
  • 16. Ruiz-Minaya M M-VE, Vasquez-Jimenez W, Perez-Burrel L, Aracil-Moreno I, Agra-Pujol C, Bernal-Claverol M, Martínez-Bernal BL, Muñoz-Fernández M, Morote-Gonzalez M, Ortega MA, Lizarraga-Bonelli S, De Leon-Luis JA. Retrospective Analysis of Patients with Gynaecological Uterine Sarcomas in a Tertiary Hospital. J Pers Med. 2022 Feb 6;12(2):222.
  • 17. Oliva E CM, Carinelli SG, et al. Mesenchymal Tumors of the Uterus. In: Kurman RJ, Carcangiu ML, Herrington CS, Young RH, eds. WHO Classification of Tumours of Female Reproductive Organs. 4th ed. Lyon, France: IARC Press, 2014. 135-147.
  • 18. Amin MB ES, Greene FL, et al, eds. AJCC Cancer Staging Manual. 8th ed. New York: Springer; 2017.
  • 19. Kostov S KY, Ivanova V, Dzhenkov D, Metodiev D, Watrowski R, Ivanova Y, Slavchev S, Mitev D, Yordanov A. New Aspects of Sarcomas of Uterine Corpus - A Brief Narrative Review. Clin Pract. 2021 Nov 22;11(4):878-900. doi: 10.3390/clinpract11040103.
  • 20. Suchetha S VT, Rema P, Sivaranjith J, Kumar A, Krishna KMJ, James FV. Uterine Sarcoma: Retrospective Study From A Single Institute. J Obstet Gynaecol India. 2022 Aug;72(Suppl 1):306-312. doi: 10.1007/s13224-021-01612-9.
  • 21. Sait HKA, N.M.; El Sayed, M.E.; Alkhayyat, S.S.; Ghanem, A.T.; Abayazid, R.M.; Sait, K.H. Uterine sarcoma. Clinicopathological characteristics and outcome. Saudi Med. J. 2014, 35, 1215–1222.
  • 22. Wang F DX, Chen H, Hu X, Wang Y. Clinical characteristics and prognosis analysis of uterine sarcoma: a single-institution retrospective study. BMC Cancer. 2022 Oct 7;22(1):1050. doi: 10.1186/s12885-022-10129-x.
  • 23. Gao Y, Meng H, Zhang Y, Jiao T, Hui N. Retrospective analysis of 80 cases with uterine carcinosarcoma, leiomyosarcoma and endometrial stromal sarcoma in China, 1988-2007. Int J Clin Exp Pathol. 2014 Mar 15;7(4):1616-24.
  • 24. Nano, O.; Nieto, M.J.; Saif, M.W.; Tarabichi, M. Retrospective Analysis of Patients with Gynecological Uterine Sarcomas: Leiomyosarcomas and other Histological Subtypes at a Single Institution from 1996 to 2015. Cancer Med. J. 2020, 3, 30–37.
  • 25. Ronsini C FA, Giudice M, Reino A, La Verde M, Della Corte L, Bifulco G, Franciscis P, Cianci S, Capozzi VA. Is Adnexectomy Mandatory at the Time of Hysterectomy for Uterine Sarcomas? A Systematic Review and Meta-Analysis. Medicina (Kaunas). 2022 Aug 23;58(9):1140. doi: 10.3390/medicina58091140.
  • 26. Reed NS MC, Malmströ m H, et al. Phase III randomized study to evaluate the role of adjuvant pelvic radiotherapy in the treatment of uterine sarcomas stages I and II: A European Organisation for Research and Treatment of Cancer Gynaecological Cancer Group Study (protocol 55874). Eur J Cancer 2008;44:808-818.
  • 27. Nam JH. Surgical treatment of uterine sarcoma. Best Pract Res Clin Obstet Gynaecol 2011;25:751-760.
  • 28. Barquet-Muñoz, S.A.; Isla-Ortiz, D.; Montalvo-Esquivel, G.; Cantú-de-León, D.; Salcedo-Hernández, R.A.; Cordoba-Gonzalez, V.; Herrera-Gómez, Á. Prognostic factors associated with uterine sarcomas: The experience of a single institution. J. Obstet. Gynaecol. 2019, 39, 231–236.
  • 29. Li D YN, Du G, Wang S, Xiao Z, Chen J, Chen W. A Real-World Study on Diagnosis and Treatment of Uterine Sarcoma in Western China. Int J Biol Sci. 2020 Jan 1;16(3):388-395. doi: 10.7150/ijbs.39773.
  • 30. Wang LL, S.; Zhang, Z.; Jia, J.; Shan, B. Prevalence and occult rates of uterine leiomyosarcoma. Medicine 2020, 9, e21766.
  • 31. Nordal RN KK, Stenwig AE, Tropé CG. Leiomyosarcoma (LMS) and endometrial stromal sarcoma (ESS) of the uterus. A survey of patients treated in the Norwegian Radium Hospital 1976 - 1985. Int J Gynecol Cancer 1993;3:110-115.
  • 32. Coussens LM, Werb Z. Inflammation and cancer. Nature. 2002 Dec 19-26;420(6917):860-7. doi: 10.1038/nature01322.
  • 33. Szkandera J AG, Liegl-Atzwanger B, Pichler M, Stotz M, Samonigg H, Glehr M, Zacherl M, Stojakovic T, Gerger A, Leithner A. Elevated preoperative neutrophil/lymphocyte ratio is associated with poor prognosis in soft-tissue sarcoma patients. Br J Cancer. 2013 Apr 30;108(8):1677-83. doi: 10.1038/bjc.2013.135.
  • 34. Jeong MJ PJ, Hur SY, Kim CJ, Nam HS, Lee YS. Preoperative Neutrophil-to-Lymphocyte Ratio as a Prognostic Factor in Uterine Sarcoma. J Clin Med. 2020 Sep 8;9(9):2898. doi: 10.3390/jcm9092898.
Toplam 34 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Onkoloji, Klinik Tıp Bilimleri (Diğer)
Bölüm Original Article
Yazarlar

Fazıl Avcı 0000-0002-9244-9168

Belma Gözde Özdemir 0000-0002-7025-4087

Mehmet Kulhan 0000-0002-5478-7510

Ahmet Bilgi 0000-0001-8682-1739

Cetin Celik 0000-0001-6165-5092

Yayımlanma Tarihi 28 Şubat 2025
Gönderilme Tarihi 9 Şubat 2024
Kabul Tarihi 20 Ocak 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 35 Sayı: 1

Kaynak Göster

Vancouver Avcı F, Özdemir BG, Kulhan M, Bilgi A, Celik C. Prognostic and Predictive Factors for Uterine Sarcomas: A Single Center Experience. Genel Tıp Derg. 2025;35(1):7-15.