Prognostic factors in patients with uterine sarcoma: the SARCUT study
Ignacio Zapardiel 1 , Myriam Gracia Segovia 2 , Ronalds Macuks 3 , Rosanna Mancari 4 5 , Patriciu Achimas-Cadariu 6 , Giacomo Corrado 7 , Arnoldas Bartusevicius 8 , Vladyslav Sukhin 9 10 , Juan C Muruzabal 11 , Pluvio J Coronado Martín 12 , Barbara Gardella 13 , Jurgen M Piek 14 , Nicole Concin 15 16 , Clemente Arab 17 , Dimitrios Papatheodorou 18 , Stephan Polterauer 19 , Sara Iacoponi 2 , Teresa Nieto 20 , Martha C Lopez-Sanclemente 21 22 , Hanna Trukhan 23 , Maria M Gil 2 , Irina Bakinovskaya 23 , Alena Dalamanava 23 , Marc Cucurull 24 , Dzmitry Rovski 23 , Laura Baquedano 25 , Luis Chiva 26 , Marcin Mardas 27 , Siarhei Anatolievich Mavrichev 28 , Jaroslav Klat 29 , Carlos A Lopez de la Manzanara 30 , Yusuf Yildirim 31 ; SARCUT Study Group
Objective: Uterine sarcomas are a rare and heterogeneous group of malignancies that include different histological sub-types. The aim of this study was to identify and evaluate the impact of the different prognostic factors on overall survival and disease-free survival of patients with uterine sarcoma.
Methods: This international multicenter retrospective study included 683 patients diagnosed with uterine sarcoma at 46 different institutions between January 2001 and December 2007.
Results: The 5-year overall survival for leiomyosarcoma, endometrial stromal sarcoma, undifferentiated sarcoma, and adenosarcoma was 65.3%, 78.3%, 52.4%, and 89.5%, respectively, and the 5-year disease-free survival was 54.3%, 68.1%, 40.3%, and 85.3%, respectively. The 10-year overall survival for leiomyosarcoma, endometrial stromal sarcoma, undifferentiated sarcoma and adenosarcoma was 52.6%, 64.8%, 52.4%, and 79.5%, respectively, and the 10-year disease-free survival was 44.7%, 53.3%, 40.3%, and 77.5%, respectively. The most significant factor associated with overall survival in all types of sarcoma except for adenosarcoma was the presence of residual disease after primary treatment. In adenosarcoma, disease stage at diagnosis was the most important factor (hazard ratio 17.7; 95% CI 2.86 to 109.93).
Conclusion: Incomplete cytoreduction, tumor persistence, advanced stage, extra-uterine and tumor margin involvement, and the presence of necrosis were relevant prognostic factors significantly affecting overall survival in uterine sarcoma. The presence of lymph vascular space involvement and administration of adjuvant chemotherapy were significantly associated with a higher risk of relapse.
CITATION Int J Gynecol Cancer. 2023 May 16;ijgc-2022-004204. doi: 10.1136/ijgc-2022-004204.