e15522 Background: Uterine sarcomas behave aggressively and are associated with poor prognosis. Carcinosarcomas was re-classified as more akin to endometrial adenocarcinomas. The objective was to analyze the survival outcomes of all uterine sarcomas treated with various combinations of chemotherapy, radiation, and lymph node dissections. Methods: 60 patients with proven uterine sarcomas were treated at Hahnemann Hospital from 2002-2011. Survival analyses in each treatment group were performed by Kaplan- Meier method Results: Among the 60 women examined, 51% were carcinosarcoma, 25% leiomyosarcoma, 20% endometrial stromal sarcoma, and 4% adenosarcoma. 27% presented with stage I disease, 20% stage II, 13% stage III, and 40% with metastatic disease at diagnosis. One third of the leiomyosarcomas and endometrial stromal sarcomas have advanced disease at diagnosis. Median survival of all patients was 26 months, 20 months for carcinosarcoma, 25 months for high grade endometrial stromal sarcoma, and a trend toward superior overall survival at 73 months for leiomyosarcoma. After surgery, 51% of patients mostly carcinosarcomas received carboplatin and paclitaxel as adjuvant chemotherapy and 66% of leiomyosarcomas received gemcitabine and docetaxel. However, the survival analysis showed no statistically significant benefit in disease progression free survival. On the other hand, 50% of patients were also treated with adjunctive pelvic external beam radiation and 21% received additional vaginal brachytherapy. Our results demonstrated a small but clear survival benefit after pelvic radiation therapy. Pelvic lymphadenectomy was performed in 55% of these patients and lymph node involvement was found in 30% of uterine sarcomas mostly carcinosarcomas. Survival analysis indicated that pelvic lymphadenectomy was associated with significant survival benefit. Conclusions: Size, stage, nodal involvement, and histology are independent prognostic factors. Complete cytoreduction followed by lymph node dissection, and radiation therapy offered a survival advantage than surgery alone. However, the role of adjuvant chemotherapy remains uncertain.
440 Survival analysis of uterine sarcomas in the province of las palmas 2009–2018
