Abstract 26P
Background
Uterine sarcomas (US) are rare tumors, representing less than 3% of gynecologic malignancies and between 3% and 7% of uterine malignancies. US are characterized by being aggressive with a high rate of local and metastatic recurrence. Their management is not well codified. The aim of our study was to investigate the epidemiological, clinical, therapeutic, and prognostic characteristics of US.
Methods
This was a monocentric, descriptive, retrospective study that included patients with US treated in Salah Azaiez Tunisian oncological institute between 2000 and 2020.
Results
The study included 103 patients. The average age was 50 years. Menometrorrhagia was the main circumstance of discovery (n=70). In 73.8% of cases, the diagnosis was postoperative. Histological confirmation was done on hysterectomy specimen in 82 patients. The most frequent histological type was leiomyosarcoma in 72.8% of cases. Stage I was the most represented (41.7%). Ninety-seven patients underwent surgery, 87 of them had a total hysterectomy associated with bilateral salpingo-oophorectomy and lymph node dissection. Adjuvant chemotherapy was indicated in 16.5% of cases. Adjuvant pelvic radiotherapy was performed in 35 patients. Thirty-one patients received first-line chemotherapy. The protocol used was the combination of doxorubicin and ifosfamide in 82.3% of cases. Two patients received palliative endocrine therapy after progression to first line. After a median follow-up of 56 months, the overall survival at 2 and 5 years, all stages combined, was 56% and 40%, respectively. For metastatic stages, the overall survival was 36% and 25% at 2 and 3 years, respectively. In multivariate analysis, no prognostic factors were identified. Progression-free survival at 3 and 5 years was 82% and 72%, respectively. In multivariate analysis, only the circumstance of discovery was a prognostic factor impacting progression-free survival (p=0.042).
Conclusions
US is a particular neoplasm. Prospective randomized studies are needed to better codify its management.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.