Sarcoma of the uterus: a clinical study of 42 patients

Records of 42 patients with a diagnosis of uterine sarcoma treated between 1974 and 1995 at the Department of Oncology and Radiotherapy, Medical University of Gdansk have been reviewed. There were 15 cases of leiomyosarcoma, 14 cases of carcinosarcoma (malignant mixed mesodermal tumor) and 13 cases of endometrial stromal sarcoma. There were 24 FIGO stage I patients, 3 stage II patients, 7 stage III patients and 8 stage IV patients. Thirty seven patients had previously been operated on, of whom 33 had undergone total abdominal hysterectomy and bilateral salpingoophorectomy. Adjuvant postoperative treatment was administered in 19 patients and included radiotherapy in 16 patients, chemotherapy in two and chemotherapy and irradiation in one. Out of 31 radically operated patients, 19 (61%) had recurrences, within 2-42 months of primary treatment (median 10 months); nine patients had distant metasases, six patients had local recurrence and four had both local and distant failure. Treatment failure occurred in seven out of 14 patients who received adjuvant radiotherapy and in 12 out of 17 treated without irradiation. Median survival time in both groups was 26 months. The survival for the whole series ranged from 2 months to 19+ years (median 26 months) and was not related to tumor type. Two and five year actuarial survival rates were 54% and 30%, respectively.