Uterine sarcomas. Diagnostics and treatment

Abstract

Objective: Sarcomas of uteri are rare tumors, 0,7 cases among 100 000 female population. Developing interstially tumors is characterized by early and rapid metastatic spread. Than we identified clinical and pathological specialties of diagnosis, treatment, follow-up and prognosis form patients with sarcomas of uteri.

Full Text

Methods: We analyzed features of 419 patients with sarcomas of uteri which were treated from 1968 to 1995 years at N. N. Petrov Research Institute of Oncology and at St. Petersburg Cancer Hospital.

Results: The average age of patients was 55 years. Leiomyosarcomas (LMS) were in 49,6% cases, endometrial stromal sarcomas (ESS) — in 19,3%, mixed mesodermal sarcomas (MMS) — in 27,5% and in 3,5% cases were observed another type of tumor. Majority of patients with MMS were menopausal (75%) and have changes of metabolism of lipids and carbohydrates such as patients with endometrial cancer. The 5-year survival rates were 42,7%. LMS - 49,5%, ESS - 43,5%, MMS - 32,1%, in early stages — 58,9%, in locally advanced tumors — 12,5%, respectively. The nonfavourable prognosis in LMS was in cases if mitosis activity rises were more then 10%, in MMS — if depth of invasion was more than 10 mm. Hysterectomy with adnexectomy is an equivalent operation in sarcomas of uteri, but in addition to ones with lymphadenectomy in MMS. Postoperative radiation is indicated for all histological types excepting LMS. For all patients are recommended adjuvant chemotherapy with adriamycin.

Conclusion: Our investigations indicate that histological type and extend of disease have a prognostic significance and could influence to diagnosis, treatment, follow-up and prognosis of patients with sarcomas of uteri.