Uterine Sarcomas: Surgical Management, Adjuvant Therapy and Survival Outcome. Experience at Gujarat Cancer and Research Institute

Abstract

Uterine sarcomas are rare, accounting for 7–8% of all uterine cancers and less than 1% of all female genital tract cancers. Surgery is a cornerstone in the treatment, and addition of radiotherapy, chemotherapy or hormonal therapy depends on the stage of the disease. Due to its rarity, heterogeneity and aggressiveness, there is no consensus and there is scarce evidence regarding the optimal therapeutic approaches. Our aim was to study the cases of uterine sarcoma in terms of clinical and histopathological characteristics, prognostic factors and outcome analysis. This is a retrospective study of all cases of histological proven uterine sarcoma identified between January 2001 and December 2013 at the Department of Gynecologic Oncology, Gujarat Cancer and Research Institute, Ahmedabad. The data regarding the patients’ characteristics, tumor characteristics, various treatment modalities, operative details, follow-up, recurrence and survival were reviewed and recorded. Total 57 were included in our study. Leiomyosarcoma was the most common histopathological type. Twenty-four cases were stage 1 and were kept on observation. Almost 50% of the patients in our study recurred during our study period. Overall 64% of the patients survived till 3 years and 53% till 5 years of follow-up. Twenty-six percent of the case died within first year of completion of treatment. The management of uterine sarcomas is challenging due to the rare occurrence, lack of consensus or guidelines and adequate literature. Adjuvant treatment should be individualized.