Prognostic factors and the impact of different classification systems in the gynecologic sarcomas (GS) outcome

Abstract

21505 Background: Prognostic factors for GS used in available studies are the presence of metastasis, performance status and factors included in FIGO staging. The objective of this retrospective study was to analyze clinical and pathological prognostic factors, trying to improve the usual (FIGO) classification. Methods: We analyzed 75 patients with ovarian (11) or uterine sarcoma (64) diagnosed from 6/1983 to 12/2007. Pathology: 26 leiomyosarcoma, 35 carcinosarcoma, 10 endometrial stromal, 4 high-grade undifferentiated sarcoma. Results: Medium age was 57 (26–82) years. With a median follow-up of 30.4 months (6–305), 5-year and 10-year survival was 71% and 69%. Survival significant prognostic factors in the univariate analysis: histologic subtype (stromal 100%, leiomyo 69%, carcinosarcoma 64%, undifferentiated 50%, p=0.01); tumor grade (I=100%, II=80%, III=58%, p=0.0003); AJCC sarcoma staging (I=100%, II=71%, III=68%, IV=55%, p=0.005); FIGO staging (I=89%, II=67%, III=58%, IV=50%, p=0.004). Disease relapse occurred in 36 (48%) patients: local only 54%, distant 31%, both 15%. Median time to relapse 13 months, 5-year and 10-year survival was 38% and 32%. Median survival in local vs distant recurrence was 21 and 13 months (non-significant). 5-year survival in radical intention treatment of relapse was 65% vs 13% in palliative setting patients (p<0.001). Conclusions: Histologic type and tumor grade should be considered prognostic factors in GS. FIGO and AJCC staging methods have a good correlation with prognosis. Radical treatment (surgery ± radiotherapy) of relapsed disease should be always considered. No significant financial relationships to disclose.