Uterine Sarcoma: Clinical Presentation, Treatment and Survival Outcomes in Thailand

Potikul, Chalermrat; Tangjitgamol, Siriwan; Khunnarong, Jakkapan; Srijaipracharoen, Sunamchok; Thavaramara, Thaovalai; Pataradool, Kamol

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저자정보: Potikul, Chalermrat (Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University) Tangjitgamol, Siriwan (Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University) Khunnarong, Jakkapan (Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University) Srijaipracharoen, Sunamchok (Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University) Thavaramara, Thaovalai (Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University) Pataradool, Kamol (Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University)

저널정보: 아시아태평양암예방학회 Asian Pacific journal of cancer prevention : APJCP Asian Pacific journal of cancer prevention : APJCP 제17권 제4호

발행연도: 2016.1

수록면: 1,759 - 1,767 (9page)

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Background: Uterine sarcoma is a group of rare gynecologic tumors with various natures, and different lines of treatment. Most have a poor treatment outcome. This study targeted clinical characteristics, treatment, overall survival (OS), progression-free survival (PFS), and prognostic factors in uterine sarcoma patients in one tertiary center for cancer care. Materials and Methods: Uterine sarcoma patients who were treated at the Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital between January 1994 and December 2014 were identified. Clinico-pathological data were analyzed. Prognostic outcomes were examined by Kaplan-Meier curves and Cox regression analysis. Results: We identified 46 uterine sarcoma patients: 25 carcinosarcoma (CS) (54.3%), 15 leiomyosarcoma (LMS) (32.6%), and 6 undifferentiated uterine sarcoma (UUS) (13.1%) cases. Mean age was $54.0{\pm}11.9years$ (range 25-82 years). Abnormal uterine bleeding was the most common presenting symptom (63.0%). Among 33 patients (71.7%) who had pre-operative tissue collected, diagnosis of malignancy was correct in 29 (87.9%). All patients received primary surgery and retroperitoneal lymph nodes were resected in 34 (73.9%). After surgery, 5 (10.9%) had gross residual tumors. Stage I disease was most commonly found (56.5%). Adjuvant treatment was given to 27 (58.7%), most commonly chemotherapy. After a median follow-up of 16.0 months (range 0.8-187.4 months), recurrence was encountered in 22 patients (47.8%). Median time to recurrence was 5.8 months (range1.0-105.5 months). Distant metastasis was more common than local or locoregional failure. The 2-year PFS was 45.2% (95% confidence interval [CI], 30.6%-59.7%) and the 2-year OS was 48.3% (95% CI, 33.3%-60.7%). Multivariable analyses found residual disease after surgery as a significant factor only for PFS. Conclusions: Uterine sarcoma is a rare tumor entity. Even with multimodalities of treatment, the prognosis is still poor. Successful cytoreductive surgery is a key factor for a good survival outcome.

#Uterine sarcoma #clinical characteristics #survival #prognostic factors #Thailand

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Potikul, Chalermrat

소속기관 Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj Unive