Uterine sarcomas: prognostic factors and treatment modalities--study on 209 patients

From 1975 through 1984, 209 patients with uterine sarcoma were studied in 13 French Oncology Centers. The repartition by histologic type was the following: 31 patients (PTS) with carcinosarcoma, 81 PTS with leiomyosarcoma, 27 PTS with endometrial sarcoma, and 70 PTS with mullerian mixed mesodermal tumors. The prognostic factors were analyzed using a proportional hazards regression model. The analysis of prognostic factors showed that the strongest predictor of survival was menopausal status. Increasing tumor extension and increasing WHO performance status were also prognostic factors. No significant difference for prognosis was found for histologic type, operability, and age. Two-year survival rates were quite similar for all kinds of treatment, being 58.0% for tumor extension T1 and T2 and 35.0% for tumor extension T3 and T4. Two-year recurrence and metastasis rates were lower with addition of radiotherapy or chemotherapy without any benefit on survival rates. Cooperative clinical trials including all histologic types should be undertaken to improve survival. The knowledge of the prognostic factors can help to refine treatment comparisons.