Uterine Sarcoma Treatment (PDQ®): Treatment - Health Professional Information [NCI] - General Information About Uterine Sarcoma
The above factors in addition to the following ones correlate with a progression-free interval:
- Adnexal spread.
- Lymph node metastases.
- Tumor size.
- Peritoneal cytologic findings.
- Depth of myometrial invasion.
Factors that bear no relationship to the presence or absence of metastases at surgical exploration are:
- The presence or absence of stromal heterologous elements.
- The types of such elements.
- The grade of the stromal components.
- The mitotic activity of the stromal components.
In one study, women with a well-differentiated sarcomatous component or carcinosarcomas had significantly longer progression-free intervals than those with moderately to poorly differentiated sarcomas for the homologous and heterologous types. The recurrence rate was 44% for homologous tumors and 63% for heterologous tumors. The type of heterologous sarcoma had no effect on the progression-free interval.
For women with leiomyosarcomas, some investigators consider tumor size to be the most important prognostic factor; women with tumors greater than 5.0 cm in maximum diameter have a poor prognosis. However, in a Gynecologic Oncology Group study, the mitotic index was the only factor significantly related to progression-free interval. Leiomyosarcomas matched for other known prognostic factors may be more aggressive than their carcinosarcoma counterparts. The 5-year survival rate for women with stage I disease, which is confined to the corpus, is approximately 50% versus 0% to 20% for the remaining stages.
Surgery alone can be curative if the malignancy is contained within the uterus. The value of pelvic radiation therapy is not established. Current studies consist primarily of phase II chemotherapy trials for patients with advanced disease. Adjuvant chemotherapy following complete resection for patients with stage I or II disease was not established to be effective in a randomized trial. Yet, other nonrandomized trials have reported improved survival following adjuvant chemotherapy with or without radiation therapy.[11,12,13]
Other PDQ summaries containing information related to uterine sarcoma include the following:
- Adult Soft Tissue Sarcoma Treatment
- Childhood Soft Tissue Sarcoma Treatment
- Endometrial Cancer Prevention
- Endometrial Cancer Screening
- Endometrial Cancer Treatment
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- Evans HL, Chawla SP, Simpson C, et al.: Smooth muscle neoplasms of the uterus other than ordinary leiomyoma. A study of 46 cases, with emphasis on diagnostic criteria and prognostic factors. Cancer 62 (10): 2239-47, 1988.
- Oláh KS, Dunn JA, Gee H: Leiomyosarcomas have a poorer prognosis than mixed mesodermal tumours when adjusting for known prognostic factors: the result of a retrospective study of 423 cases of uterine sarcoma. Br J Obstet Gynaecol 99 (7): 590-4, 1992.
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