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.

Catalan Institute of Oncology L'Hospitalet de Llobregat Catalunya Spain

Department of Gynecological Oncology Poznan University of Medical Sciences Poznan Wielkopolskie Poland

Department of Gynecology and Obstetrics Innsbruck Medical Univeristy Innsbruck Austria

Department of Obstetrics and Gynaecology Lithuanian University of Health Sciences Kaunas Lithuania

Division of General Gynecology and Gynecologic Oncology Department of Obstetrics and Gynecology Gynecologic Cancer Unit Comprehensive Cancer Center Medical University of Vienna Vienna Austria

Gynecologic Oncology Department Catharina Hospital and Catharina Cancer Institute Eindhoven Netherlands

Gynecologic Oncology Department Clinica Diatros Barcelona Spain

Gynecologic Oncology Department Fondazione IRCCS Policlinico San Matteo Pavia Italy

Gynecologic Oncology Department Hospital General Universitario de Ciudad Real Ciudad Real Castilla La Mancha Spain

Gynecologic Oncology Department Hospital Luis Tisné Universidad de Chile Santiago Chile

Gynecologic Oncology Department Hospital Universitario Miguel Servet Zaragoza Spain

Gynecologic Oncology Department Hospital Universitario Santa Cristina Madrid Spain

Gynecologic Oncology Department IRCCS Milan Italy

Gynecologic Oncology Department IRCCS Regina Elena National Cancer Institute Rome Italy

Gynecologic Oncology Department Metaxa Memorial Cancer Hospital Piraeus Greece

Gynecologic Oncology Department N N Alexandrov National Cancer Center Minsk Belarus

Gynecologic Oncology Department Tepecik Training and Research Hospital Clinics Konak Izmir Turkey

Gynecologic Oncology Department The Oncology Institute 'Prof Dr Ion Chiricuta' Cluj Napoca Cluj Napoca Romania

Gynecologic Oncology Department Torrecárdenas Hospital Complex Almeria Andalucía Spain

Gynecologic Oncology Unit Complejo Hospitalario de Navarra Pamplona Navarra Spain

Gynecologic Oncology Unit Hospital Clinico San Carlos Madrid Comunidad de Madrid Spain

Gynecologic Oncology Unit La Paz University Hospital Madrid Spain

Gynecological Oncology N N Alexandrov National Cancer Center Minsk Belarus

Karl Landsteiner Institute for General Gynecology and Experimental Gynecologic Oncology Vienna Austria

Obstetrics and Gynecology Clinica Universidad de Navarra Madrid Spain

Obstetrics and Gynecology Department University Hospital Ostrava Ostrava Moravskoslezský Czech Republic

Oncogynecology Grigoriev Institute for Medical Radiology NAMS of Ukraine Harkiv Ukraine

Oncology Radiology and Radiation Medicine 5 N Karazin Kharkiv National University Harkiv Ukraine

Policlinico Universitario Agostino Gemelli Dipartimento Scienze della Salute della Donna e del Bambino Roma Italy

Riga East Clinical University Hospital Latvian Oncology Center Riga Latvia

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