Treatment of pure uterine sarcoma at the Institut Català D'Oncologia

The aim of this retrospective study was to investigate the clinical and histopathological characteristics of the disease and treatment outcome of patients with pure uterine sarcomas.

Uterine sarcomas are especially rare tumours, comprising only 3-5% of uterine cancers. They are characterized by histopathological diversity, rapid clinical progression, and poor prognosis. Optimal management consists of complete surgical removal and adjuvant radiotherapy may improve the prognosis.

All patients with pure uterine sarcoma histology treated at our centre, the Institut Català D'Oncologia in Barcelona Spain, between 2002 and 2010 were reviewed.

Records of 17 patients treated at our hospital over an 8-year period were obtained. Nine patients (53%) had leiomyosarcoma, 7 (41%) had endometrial stromal sarcoma, and 1 patient had unclassified sarcoma. All patients were treated with external beam radiation after surgical excision. Mean age was 62 years (range, 51-69 years). Of the 17 patients, 13 (76%) presented with stage I disease, 2 (12%) were stage II, and 2 (12%) stage III. The overall actuarial 2-year survival estimate was 82.5%. Two patients experienced local relapse. The 2-year local control rate was 90%. A total of 5 patients experienced either local or metastatic relapse. The 2-year progression free survival rate was 58%.

In our experience, combined treatment (surgery and adjuvant radiation therapy) is effective with acceptable side effects. Larger and multicenter studies are needed to assess treatment outcome for pure uterine sarcoma histology.