Gynecology Oncology
Ahmad Shuib Yahaya; Mohd Norazam Mohd Abas; Jamil Omar
Articles in Press, Accepted Manuscript, Available Online from 18 November 2023
Abstract
Objective:
This study aims to analyze the survival outcomes and prognostic factors of patients with uterine sarcoma in the Department of Gynae-Oncology, between June 2015 and December 2022.
Methods:
The study population consists of patients with histopathologically confirmed uterine sarcoma. Oncological ...
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Objective:
This study aims to analyze the survival outcomes and prognostic factors of patients with uterine sarcoma in the Department of Gynae-Oncology, between June 2015 and December 2022.
Methods:
The study population consists of patients with histopathologically confirmed uterine sarcoma. Oncological data collected includes stage, pathological report and type of surgery, adjuvant therapy, recurrence, and mortality. Kaplan-Meier analysis used to estimate survival.
Results:
We identified 58 eligible uterine sarcoma patients: 13 leiomyosarcoma (22.4%), 9 endometrial stromal sarcoma (15.5%), 32 carcinosarcoma (55.2%), 2 adenosarcoma (3.4%) and another 2 were undifferentiated sarcoma (3.4%). Mean age was 56.1 (SD=12.03) and 56% patients were postmenopausal. Majority of patients presented in stage III and IV (53.4%) and only 22 patients (37.9%) in stage I. Adjuvant radiotherapy was given to 21 patients (36.2%); 8 patients (13.8%) received chemotherapy and 9 patients (15.5%) received both radiotherapy and chemotherapy. Median follow up period was 13.5 months (range: 73 months) and total of 35 patients (60.3%) had recurrence with median time to recurrence of 6.0 months (range: 35). Death occurred in 21 patients (36.2%) with median time to death 5.0 months (range: 36 months). Progression free survival (PFS) among all patients was 26.64 (range: 4.32) months with significant correlation with stage of disease. Overall survival (OS) in patients received surgery only, radiotherapy and combine radiotherapy and chemotherapy were 23.3, 54.8 and 62.4 months respectively (p value 0.03).
Conclusion:
Uterine sarcoma is a relatively rare tumor type with worse survival. Multimodality adjuvant treatments showed to improve prognosis in those patients.
Nadereh Behtash; Setareh Akhavan
Volume 4, Issue 3 , September and October 2019, , Pages 120-126
Abstract
Uterine sarcomas (US) are relatively rare malignant tumor of the uterine mesenchymal tumor. The present study evaluated the outcomes of patients with different types of uterine sarcoma in Iranian women during a 5-years survey. During 2014-2019, a case series of twenty-three patients of US (four cases ...
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Uterine sarcomas (US) are relatively rare malignant tumor of the uterine mesenchymal tumor. The present study evaluated the outcomes of patients with different types of uterine sarcoma in Iranian women during a 5-years survey. During 2014-2019, a case series of twenty-three patients of US (four cases of leiomyosarcoma (LMS), nine cases of endometrial stromal sarcoma (ESS), seven cases of carcinosarcoma (CS), and three cases of adenosarcoma (AS)) were studied. One case of AS needed adjuvant radiotherapy and a recurrence was occurred in this case four years later. Two cases of CS have died during study period. All of ESS cases were alive by the study duration. One case who did not receive radio/chemotherapy experienced a bronchial recurrence after 8-years of ESS diagnosis Immunohistochemistry test on tumoral cells of three patients for vimentin+Ki67, BCL2+CD64+Ki67, ER+PR+WT1+Ki67 expressions were 30%, 30%, 15% respectively. Two cases of CS died during the study period. Even with multimodalities of treatment, the prognosis of uterine sarcoma is still poor and early diagnosis seems to improve the prognosis of the patients.
Soheila Aminimoghaddam; Sahereh Arabian; Shirin Haghighi; Ladan Haghighi
Volume 1, Issue 1 , May and June 2016
Abstract
Introduction: Sarcoma of the cervix is uncommon and its prevalence is about 1% of malignancies of the cervix. One type of sarcoma is leiomyosarcoma and the location of this tumor in cervix is very rare. Although uterine sarcoma can involve the cervix and lead to misdiagnosis of cervical leiomyosarcoma, ...
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Introduction: Sarcoma of the cervix is uncommon and its prevalence is about 1% of malignancies of the cervix. One type of sarcoma is leiomyosarcoma and the location of this tumor in cervix is very rare. Although uterine sarcoma can involve the cervix and lead to misdiagnosis of cervical leiomyosarcoma, the location of the bulk of the tumor in uterine cervix (not isthmus) for diagnosis of cervical leiomyosarcoma is mandatory. The origin of sarcoma is from mesodermal tissue. Due to the rarity of cervical leiomyosarcoma and response to debulking surgery after recurrence, report of this case is interesting.
Case Presentation: We hereby report on a 34-year-old unmarried patient, who was a known case of leiomyosarcoma of uterine cervix that was referred with recurrence of tumor in parietal peritoneum, retropobic retzius space and around the bladder and ureter and sigmoid colon. The patient was treated with debulking surgery of the tumor and chemotherapy.
Conclusions: Sarcoma as a genital tract malignancy is very rare and the location of sarcoma at pediatric age is in the vagina and at middle age is in the cervix and at postmenopausal women in the uterine corpus. Cervical sarcoma as a rare tumor of the cervix arises from stromal tissue. Due to hematogenous spread of sarcoma, metastasis in lungs is seen and recurrence of this tumor is not uncommon. In this article, recurrence of a known case with leiomyosarcoma of uterine cervix in previous hysterectomy that responded to debulking surgery with removal of metastatic lesions in peritoneal and retroperitoneal spaces and adjuvant therapy with standard chemotherapy drugs and monoclonal antibody therapy is reported. Due to non-hormonal dependence of sarcoma to hormonal secretion from the ovaries and beneļ¬t of the ovaries in young women for protection of bone health and cardiovascular system, oophorectomy is a challenging idea and an issue of debate, thus primary surgery, in this case oophorectomy, was not done.