Retrospective analysis of 105 cases of uterine sarcoma

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 16079-16079
Author(s):  
A. Yoney ◽  
S. Eskici ◽  
B. Eren ◽  
A. Salman ◽  
M. Unsal
Keyword(s):  
Therapeutic Option ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Distant Metastases ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Uterine Sarcoma ◽  
Therapeutic Modality ◽  
Uterine Sarcomas ◽  
Pathologic Classification

16079 Background: Currently there is no randomized study based or widely accepted therapeutic modality in uterine sarcomas which are rare tumors forming a heterogeneous group in respect to their pathologic classification. Methods: In our trial, 105 pts. with uterine sarcoma who were referred to our clinic between years 1995–2003 have been retrospectively researched to evaluate the results in this tumor group. 43.8% had Leiomyosarcoma (LMS), 28.6% had Endometrial Stromal Sarcoma (ESS) and 27.6% had a Malign Mullarian Mixed Tumor (MMMT) while the distribution according to the histological subgroups were found to be 58.8% and 41.2% in low + middle grade tumors combined and in high grade tumors respectively. 76.2% had a Total Abdominal Hysterectomy + Bilateral Salphingooverectomy (TAH+BSO), 18.1% had a Total Abdominal Hysterectomy + Bilateral Salphingooverectomy + Lymphadenectomy (TAH+BSO+LND) and 5.7% had a suboptimal surgery as a surgical procedure. 38.1% of the pts. had Radiotherapy (RT), 18.1% had Chemotherapy (CT) and 12.4% had Chemo-radiotherapy (CT+RT) in addition to surgery. Results: The median age of the whole group is 51 (24–87). 55% of our pts. are under 50 years old and 68.5% had an “organ limited disease” ( stages I-II combined). The distant metastases rate is 30% and the local recurrence is 16.2%. All the local recurrences and 90% of the distant metastases have occurred within the first two years. The disease free survival rates at 3 and 5 years are 54.46% and 49.88% ; while the overall survival rates at 3 and 5 years are 54.63% and 51.09% all respectively. The stage is the most important factor effecting on the O.S and 5- year O.S rate is 68.43% in Stage I disease. Conclusions: The aggressive tumor progression pattern and the poor prognosis of uterine sarcomas require adjuvant therapies. The merit of current therapeutic options are still on debate since none of them has proved any specific effects. Planning further multi-center retrospective studies with high number of pts., a more clear description of the prognostic factors and thus the determination of the most appropriate therapeutic option is definitely needed. No significant financial relationships to disclose.

Epithelial ovarian tumors of borderline malignancy: a study of 50 cases

1992 ◽  
Vol 2 (4) ◽  
pp. 189-197 ◽  
Author(s):  
B. Piura ◽  
R. Dgani ◽  
I. Blickstein ◽  
I. Yanai-Inbar ◽  
B. Czernobilsky ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Ovarian Tumors ◽  
Adequate Treatment ◽  
Initial Surgery ◽  
Stage Ia ◽  
Borderline Malignancy

Of 50 patients with borderline epithelial ovarian tumors, 32 (64%) had serous, 17 (34%) had mucinous and one (2%) had endometrioid tumor. All patients with mucinous tumor had stage I disease, whereas 4 patients with serous tumor had stage II–III disease. Five patients (10%) were pregnant at the time of diagnosis. Seventeen patients (34%) had initial surgery with ovarian conservation and 7 of them were not subjected to further surgery. Five patients (10%) received adjuvant chemotherapy. Five-year survival and 5-year disease-free survival rates were 100% and 96.4%, respectively. It is concluded that for patients with stage IA disease unilateral salpingo-oophorectomy seems to be adequate treatment and for those with more than stage IA disease, surgery should include total abdominal hysterectomy and bilateral salpingo-oophorectomy. Although the effectiveness of chemotherapy in these tumors is uncertain, adjuvant chemotherapy is advocated for patients in whom spread of the tumor beyond the ovaries has occurred.

Does iatrogenic tumor rupture during surgery have prognostic implications for the outcome of uterine sarcomas?

2020 ◽  
Vol 30 (11) ◽  
pp. 1726-1732
Author(s):  
Virginia Benito ◽  
Amina Lubrano ◽  
Laureano León ◽  
Fernando Molano ◽  
Beatriz Pinar
Keyword(s):  
Uterine Rupture ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Endometrial Stromal Sarcoma ◽  
Uterine Sarcoma ◽  
Tumor Rupture ◽  
Uterine Sarcomas ◽  
Free Survival ◽  
Stromal Sarcoma ◽  
Gynecology And Obstetrics

ObjectiveTumor rupture during surgery is a risk factor for recurrence of sarcomas in other locations. However, the independent impact of rupture on prognosis is uncertain in uterine sarcomas. The aim of this study was to evaluate whether uterine rupture impacts outcomes in patients with uterine sarcoma.MethodsA retrospective analysis was carried out of all consecutive patients with uterine sarcoma managed at the Department of Gynecology and Obstetrics of the Complejo Hospitalario Universitario Insular-Materno Infantil of the Canary Islands, Spain between January 1990 and December 2016. Inclusion criteria included all patients with histologically proven uterine sarcoma. Exclusion criteria included patients with endometrial carcinoma (non-sarcomatous) and carcinosarcomas. During this period, 1981 patients were diagnosed with a uterine malignancy; 1799 were excluded because of a diagnosis of endometrial carcinoma and 85 patients were excluded for a diagnosis of carcinosarcoma. Thus, the final sample included 97 patients with uterine sarcoma (4.9%). These included leiomyosarcoma, endometrial stromal sarcoma, adenosarcoma, and liposarcoma. Surgical resection was the primary treatment, including open, laparoscopic and vaginal surgery. Survival rates were analyzed using the Kaplan–Meier method.ResultsThe median age was 52 years (range 25–90); 49.5% (48) were pre-menopausal. Distribution per histological type was: 46.4% (45) leiomyosarcoma, 23.7% (23) high-grade endometrial stromal sarcoma, 17.5% (17) low-grade endometrial stromal sarcoma, 11.3% (11) adenosarcoma, and 1% (1) liposarcoma. Uterine leiomyoma was the most frequent pre-operatively suspected diagnosis (49.5%). Iatrogenic rupture of the tumor during surgery occurred in 25.3% of cases (23). International Federation of Gynecology and Obstetrics stages I–II and III–IV were identified in 74.2% (72) and 25.8% (25) of patients, respectively. The median tumor size was 8 cm (range 2–40). The recurrence rate was 47.8% (11) for patients with intra-operative tumor rupture and 25% (17) for patients without uterine rupture (p=0.03). Disease-free survival rates at 1, 2, and 5 years for patients with uterine rupture were 72.7%, 55.4%, and 13.9%, respectively, with a median time of 39 months (95% CI 2.9 to 75). For those patients without uterine rupture, disease-free survival rates at 1, 2, and 5 years were 84.8%, 76.1%, and 71.3%, respectively, with a mean time of 208.6 months (95% CI 169 to 248.3) (p=0.01). Multivariate analysis showed that stage, histological type, and iatrogenic tumor rupture during surgery were all independent prognostic factors for overall survival (OR 7.9, 95% CI 1.6 to 38.2, p=0.01); OR 5.3, 95% CI 2.1 to 13, p<0.0001; and OR 2.6, 95% CI 1.1 to 6.5, respectively, p=0.03).ConclusionConsidering that uterine sarcomas, especially leiomyosarcomas, often occur in pre-menopausal women as bulky tumors requiring laparotomy and that they are rarely diagnosed pre-operatively, efforts should be made to avoid iatrogenic uterine rupture during surgery as it impairs patient survival.

scholarly journals Recurrent Endometrial Stromal Sarcoma: Treatment with a Progestin and Gonadotropin Releasing Hormone Agonist

Sarcoma ◽  
2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Nefertiti Chianti duPont ◽  
Philip John DiSaia
Keyword(s):  
Combined Therapy ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Endometrial Stromal Sarcoma ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Good Prognosis ◽  
Low Grade ◽  
Stromal Sarcoma ◽  
Sarcoma Treatment

Endometrial stromal sarcoma (ESS) formerly classified as low-grade endometrial stromal sarcoma is a rare uterine malignancy with a good prognosis despite a tendency to recur. Primary surgical management for ESS includes total abdominal hysterectomy and bilateral salpingo-oophorectomy. Patients with ESS have long disease-free survival rates when treated with primary surgical therapy, but nearly fifty percent of these patients will recur. We present the case of a patient with recurrent ESS who had an excellent response to combined therapy with megestrol and leuprolide.

scholarly journals Could miRNA Signatures be Useful for Predicting Uterine Sarcoma and Carcinosarcoma Prognosis and Treatment?

Cancers ◽  
2018 ◽  
Vol 10 (9) ◽  
pp. 315 ◽  
Author(s):  
Laura Gonzalez dos Anjos ◽  
Bruna De Almeida ◽  
Thais Gomes de Almeida ◽  
André Mourão Lavorato Rocha ◽  
Giovana De Nardo Maffazioli ◽  
...  
Keyword(s):  
Survival Rates ◽  
Disease Free Survival ◽  
Uterine Sarcoma ◽  
Cancer Specific Survival ◽  
Uterine Sarcomas ◽  
Formalin Fixed Paraffin ◽  
Ffpe Samples ◽  
Formalin Fixed Paraffin Embedded ◽  
Rare Class ◽  
Gynecologic Neoplasms

Changes in microRNA (miRNA) expression may lead to cancer development and/or contribute to its progression; however, their role in uterine sarcomas is poorly understood. Uterine sarcomas (US) belong to a rare class of heterogeneous tumors, representing about 1% of all gynecologic neoplasms. This study aimed to assess the expression profile of 84 cancer-related miRNAs and to evaluate their correlation with clinical pathological features. Eighty-two formalin-fixed paraffin-embedded (FFPE) samples were selected. In leiomyosarcoma (LMS), there was an association of lower cancer-specific survival (CSS) with the downregulation of miR-125a-5p and miR-10a-5p, and the upregulation of miR-196a-5p and miR-34c-5p. In carcinosarcoma (CS), lower CSS was associated with the upregulation of miR-184, and the downregulation of let-7b-5p and miR-124. In endometrial stromal sarcomas (ESS), the upregulation of miR-373-3p, miR-372-3p, and let-7b-5p, and the down-expression of let-7f-5p, miR-23-3p, and let-7b-5p were associated with lower CSS. Only miR-138-5p upregulation was associated with higher survival rates. miR-335-5p, miR-301a-3p, and miR-210-3p were more highly expressed in patients with tumor metastasis and relapse. miR-138-5p, miR-146b-5p, and miR-218-5p expression were associated with higher disease-free survival (DFS) in treated patients. These miRNAs represent potential prediction markers for prognosis and treatment response in these tumors.

scholarly journals Leiomyosarcoma of Uterus in a Nulliparous Female: Mimicking as Ovarian Malignancy

2021 ◽  
Author(s):  
Jagannath Mishra ◽  
Supratim Bhattacharya ◽  
Arpita Pandia ◽  
Ashok Padhy ◽  
Manoranjan Mahapatra ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Smooth Muscle Tumor ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Uterine Sarcoma ◽  
Ovarian Malignancy ◽  
Uterine Sarcomas ◽  
Uterine Tumors ◽  
Nulliparous Female

AbstractUterine sarcoma is a rare verity of smooth muscle tumor, accounting for 2 to 6% of uterine malignancies. Leiomyosarcoma (LMS) represents ~1% of overall uterine tumors and ~25 to 36% of uterine sarcomas. Here we present a case of uterine LMS in a 34-year-old nulliparous woman presented with huge distension of abdomen which was confused to be an ovarian malignancy. She underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. The diagnosis of LMS is made by histopathological examination after surgery. Surgery is the only treatment and role of adjuvant therapy has not been clearly defined.

Cure of metastatic uterine carcinosarcoma to lungs: A case report

2003 ◽  
Vol 13 (1) ◽  
pp. 88-89
Author(s):  
A. Shamseddine ◽  
A. Taher ◽  
Y. Abou-Mourad ◽  
M. Seoud ◽  
A. Khalil
Keyword(s):  
Case Report ◽  
Systemic Chemotherapy ◽  
Pulmonary Nodules ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Uterine Sarcoma ◽  
Uterine Carcinosarcoma ◽  
Pelvic Radiotherapy ◽  
Term Survival

Most patients with advanced or recurrent uterine sarcoma experience disease progression and ultimately die. We present a case of uterine sarcoma with lung metastasis treated with systemic chemotherapy and with no evidence of disease for more than 5 years. A 77-year-old woman underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy for carcinosarcoma of the uterus followed by external pelvic radiotherapy. Ten months later, the tumor recurred in the apex of the vagina and was treated with brachytherapy. After 6 months of remission, she presented with pulmonary metastasis. After four cycles of systemic chemotherapy with cisplatin and ifosfamide, the pulmonary nodules completely disappeared. Currently she is still in complete remission after more than 5 years, but unfortunately she has developed myelodysplastic syndrome. This is the first reported case in the literature of cured metastatic uterine carcinosarcoma to lungs, with long-term survival of 5 years.

Obstructive and perforative colonic carcinoma: patterns of failure.

1985 ◽  
Vol 3 (3) ◽  
pp. 379-384 ◽  
Author(s):  
C Willett ◽  
J E Tepper ◽  
A Cohen ◽  
E Orlow ◽  
C Welch
Keyword(s):  
Massachusetts General Hospital ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Distant Metastases ◽  
Local Failure ◽  
Colonic Carcinoma ◽  
Control Group ◽  
Free Survival ◽  
Failure Patterns ◽  
Disease Free

Carcinoma of the colon complicated by obstruction or perforation has been recognized as having a poorer prognosis than tumors without obstruction or perforation. To clarify the natural history, failure patterns, and implications for adjuvant treatment after resection with curative intent, a review of the recent Massachusetts General Hospital (MGH) experience was undertaken. From 1970 to 1977, 77 patients with obstructive colonic carcinoma and 34 patients with localized perforation at the tumor site were identified and compared with a control group of 400 patients without obstruction or perforation undergoing curative resection. All patients were observed for a minimum of five years or until the patient's death. The actuarial five-year survival and disease-free survival rates in patients with obstruction was 31% and 44%, respectively, in contrast to 59% and 75% in control patients. For patients with localized perforation, the five-year actuarial survival and disease-free survival rates were 44% and 35%, respectively. Of the 77 patients with obstructing tumors, 32 patients (42%) developed local failure--nine with local failure only and 23 patients with local failure and distant metastases. Thirty-four patients (44%) developed distant metastases. Fifteen (44%) patients of 34 with perforative colonic carcinoma had local failure. Distant metastases occurred in 15 patients (44%). The incidence of local failure and distant metastases in the control group was 14% and 21%, respectively. The rate of local failure and distant metastases increased with stage and was generally higher stage for stage than in the control group.(ABSTRACT TRUNCATED AT 250 WORDS)

Endometrial Stage I Carcinoma Treated with Surgery and Adjuvant Irradiation: A Retrospective Analysis

1995 ◽  
Vol 81 (4) ◽  
pp. 256-260 ◽  
Author(s):  
Giovanni Boz ◽  
Antonino De Paoli ◽  
Roberto Innocente ◽  
Lino Del Pup ◽  
Renato Talamini ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Local Control ◽  
Combined Treatment ◽  
Distant Metastases ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Stage I ◽  
Lymph Node Sampling ◽  
Adjuvant Irradiation ◽  
Postoperative Irradiation

Aims and background Data from the literature show that the incidence of pelvic recurrences in poor prognosis endometrial carcinoma is significantly reduced by combined surgery and radiotherapy compared to surgery alone. Methods In this paper we analyze the results of the combined treatment surgery and adjuvant irradiation in patients with endometrial carcinoma with regard to survival, site of progression, and toxicity. The surgical treatment consisted of total abdominal hysterectomy and bilateral salpingo-oophorectomy in 40 patients. Pelvic and para-aortic node dissection was performed in 19 patients and lymph node sampling in 5. Results Overall 5-year survival was 85%. One patient had local failure, and 5 patients with local control of disease had distant metastases. Toxicity was mild and transient. Conclusions Our experience confirms the data of the literature. Postoperative irradiation is a safe and well-tolerated treatment that can achieve a good local control in high risk, stage I, endometrial carcinoma. The control of distant metastases remains an open question.

scholarly journals EGFR and KRAS Mutations in the Non-Tumoral Lung. Prognosis in Patients with Adenocarcinoma

2019 ◽  
Vol 8 (4) ◽  
pp. 529 ◽  
Author(s):  
Roberto Chalela ◽  
Beatriz Bellosillo ◽  
Víctor Curull ◽  
Raquel Longarón ◽  
Sergi Pascual-Guardia ◽  
...  
Keyword(s):  
Cox Regression ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Distant Metastases ◽  
Lung Parenchyma ◽  
Normal Lung ◽  
Short Term ◽  
Kras Mutations ◽  
Genetic Changes ◽  
Risk Of Progression

Tumor recurrence is frequent and survival rates remain extremely low in lung adenocarcinoma (ADC). We hypothesize that carcinogenic factors will promote loco-regional modifications not only in the future tumor, but throughout the exposed lung. Objective: To analyze whether the most prevalent mutations observed in ADC can also be observed in the non-neoplastic lung tissue, as well as the short-term prognosis implications of this finding. Methods: Non-tumoral lung parenchyma specimens obtained during surgery from 47 patients with EGFR and/or KRAS abnormalities in their ADC tumors underwent similar genomic testing. Short-term outcomes were also recorded. Results: The same mutations were present in the tumor and the histologically normal tissue in 21.3% of patients (SM group). Although local recurrences were similar in both groups, distant metastases were more frequent in the former (60 vs. 5.4%, p < 0.001). Moreover, SM patients showed lower time-to-progression (8.5 vs. 11.7 months, p < 0.001) and disease-free survival (8.5 vs. 11.2 months, p < 0.001). COX regression showed a higher risk of progression or death (DFS) in the SM group (HR 5.94, p < 0.01]. Similar results were observed when adjusting for potential confounding variables. Conclusions: These results confirm that genetic changes are present in the apparently normal lung in many ADC patients, and this finding has prognostic implications.

scholarly journals A Rare Case of Choriocarcinoma following a Normal Pregnancy and Delivery

2017 ◽  
Vol 03 (01) ◽  
pp. 064-066
Author(s):  
C Hariharan ◽  
Shubhada Jajoo ◽  
Anuradha Khemka
Keyword(s):  
Postpartum Hemorrhage ◽  
Histological Study ◽  
Distant Metastases ◽  
Total Abdominal Hysterectomy ◽  
Normal Pregnancy ◽  
Abdominal Hysterectomy ◽  
Subsequent Treatment ◽  
Time Interval ◽  
Vaginal Deliveries ◽  
Secondary Postpartum Hemorrhage

Abstract Introduction: Choriocarcinoma is one of the rarest entities encountered in routine obstetric practice. It is usually diagnosed when patient is symptomatic, presenting with either abnormal bleeding per vaginum or symptoms of distant metastases. The presentation of choriocarcinoma as secondary postpartum hemorrhage is a least common scenario. Choriocarcinoma is mostly seen following an abnormal pregnancy, either a partial or complete mole. Case report: A 25-year-old para 3 live 3 patient presented with secondary postpartum hemorrhage on 4th week postpartum. She had two normal full-term vaginal deliveries that were uncomplicated with normal antenatal period. As she presented with secondary postpartum hemorrhage with the thought of retained products of conception, an emergency diagnostic dilatation and curettage was done. Histopathology was suggestive of gestational choriocarcinoma. Patient was given single regimen of methotrexate and subsequently decision of total abdominal hysterectomy was taken and patient was kept in close follow-up. Presently, beta-human chorionic gonadotropin (hCG) is below 2 mIU/mL. Conclusion: The concern is the time interval or delay between the onset of symptoms and diagnosis with subsequent treatment. Although there are a number of reasons of postpartum hemorrhage, simple curettage for histological study and titer serum beta-hCG may lead to early diagnosis and initiation of treatment. Obstetricians and pathologists should have increased awareness regarding the consequences of choriocarcinoma.

Sign in / Sign up

Export Citation Format

Share Document