Abstract 87P
Background
Uterine sarcomas (US) represent a rare group of malignancies characterized by diverse histopathological subtypes. Due to their infrequency, scientific evidence is limited, leaving many treatment approaches open-ended. This study aims to elucidate the experience of our cancer center.
Methods
This retrospective study enrolled patients diagnosed with high-grade US between 2008 and 2024. The study objectives included evaluating population demographics and treatment modalities. Survival analyses were conducted using the Kaplan-Meier method and prognostic factors were assessed using Cox regression.
Results
Eighty-one patients with US were evaluated, of whom 53 presented with localized disease at diagnosis. The median age was 51.8 years (interquartile range [IQR] 22.3-80.9). The majority of patients had Eastern Cooperative Oncology Group Performance Status (ECOG-PS) scores of 0-1 (74%) and were diagnosed with leiomyosarcoma (92.2%). FIGO staging revealed 39.5% at stage I, 7.8% at stage II, 6.5% at stage III, 1.3% at stage IVA, and 36.4% at stage IVB. Among patients with localized disease, 67.9% underwent hysterectomy and bilateral salpingo-oophorectomy, with 86.7% achieving R0 resection. Regarding adjuvant therapy, 17% received adjuvant chemotherapy (predominantly Doxorubicin + Ifosfamide), 22.6% radiotherapy, and 13.2% brachytherapy. With a median follow-up of 52 months, 54.7% of pts recurred, primarily at distant sites (86%), notably the lungs. Median disease-free survival and overall survival were 58.5 months (IQR 9.73-154.83) and 105.17 months (IQR 37.4-121.33), respectively. Only FIGO stage was significantly associated with increased recurrence risk (HR 5.2 for stage III-IVA vs. I-II, 95% CI 1.86-14.49, P=0.002), while lymphadenectomy, adjuvant chemotherapy, or adjuvant radiotherapy did not impact recurrence risk.
Conclusions
Despite achieving high rates of R0 resection in patients with localized disease, more than half experienced recurrence, particularly at distant sites. Strategies such as lymphadenectomy and conventional adjuvant therapies (chemotherapy or radiotherapy) did not mitigate recurrence risk, highlighting the need for novel therapeutic approaches to improve outcomes.
Legal entity responsible for the study
ICESP - Instituto do Câncer do Estado de São Paulo.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.