[Malignant mesodermal mixed tumor of the uterus--a study of 37 cases]

37 patients with malignant mesodermal mixed tumor of the uterus treated from 1958 to 1987 were reviewed. It accounted for 38.5% of all uterine sarcomas during the same period. Six were homologous and 31 were heterologous in origin. The mean age was 56.8 years. 75.5% of the patients were postmenopausal. Nine (24.3%) patients had previous pelvic irradiation. There were 13 Stage I, 4 Stage II, 5 Stage III, 2 Stage IV and 13 unstaged (including 11 misdiagnosed and 2 operated in other hospital) lesions as classified according to the FIGO Staging System for malignant tumors of the Endometrium and Cervix. Twenty-six patients were treated by combined surgery and radiotherapy or chemotherapy and radiotherapy, 5 by radiotherapy alone and 6 by surgery alone. The overall 2-year survival rate was 35.1%. Twenty-two (59.5%) patients developed recurrence and/or metastasis and 86.4% (19/22) did so within 2 years after treatment. The most significant prognostic factors were: the depth of myometrial invasion, extent of lesion and method of treatment. The best 2-year survival rate (83.3%) was seen in patients treated by the combined use of surgery, radiotherapy and chemotherapy which is considered the treatment of choice for this malignancy.