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ObjectiveThe aim of this study was to determine the possible prognostic factors in patients with uterine leiomyosarcoma (LMS). MethodsThis study retrospectively investigated 50 patients with uterine LMS treated at the Samsung Medical Center between2001 and 2017. To analyze the prognostic significance of factors for recurrence-free survival (RFS), overall survival (OS),and survival after recurrence, the log-rank test and Cox proportional hazards model were used for univariate andmultivariate analysis. ResultsOf the 50 patients, 30 (60.0%) experienced recurrence and 16 (32.0%) died within a median follow-up period of 21(range, 3–99) months. Multivariate analysis revealed that older age, absence of residual tumor after surgery, lowermitotic count, and a history of adjuvant radiotherapy at first treatment were significantly associated with better RFS. Presence of residual tumor after surgery and severe nuclear atypia were associated with poor OS. In the analysis ofsurvival after recurrence, hematogenous recurrence, severe nuclear atypia, and presence of residual tumor at primarysurgery were significantly associated with worse prognosis. Notably, residual tumor status at primary surgery wasassociated with RFS, OS, and survival after recurrence. ConclusionWe demonstrated the possible prognostic factors for RFS, OS, and survival after recurrence for patients with LMS. These results may provide useful information for patients with LMS.

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