تاثیر فاکتورهای پروگنوستیک در بقای مبتلایان به سارکوم رحم

 Background: Uterine sarcomas are malignant mesenchymal neoplasms that represent three to five percent of all uterine tumors, and are classified into three major groups: 1) mixed mullerian sarcoma 2) endometrial stromal sarcoma 3) leiomyosarcoma. The purpose of this study is to determine the association of different prognostic factors with patient survival and tumor relapse. Methods: Twenty-seven patients with a previous diagnosis of uterine sarcoma were entered into this survival study. Inclusion criteria were presence of primary uterine tumor, confirmation of previous diagnosis in pathologic reassessment and availability for follow-up. We evaluated the association of overall and disease-free survival with eight factors, including FIGO stage, lymph node status, mitotic count per 10 high-power fields, vascular status, age, histology of sarcoma, myometrial depth of invasion and size of tumor.Results: The median age of our patients was 47 years, ranging from 18 to 73 years, and median time of follow-up was 28 months, ranging from 1 to 114 months. Five-year survival was 61% and the mean time of overall survival was 78 months, with a 95% confidence interval, ranging from 56 to 100 months. LSS histology type, in contrast to other subtypes, and a mitotic count of 0-9, in contrast to 20 and more, were two factors that significantly related to relapse of tumor (p<0.05). The three factors related to survival were FIGO stage (p=0.0039), mitotic count (p=0.0005) and LSS histology type in contrast to other subtypes (p< 0.05). Relapse occurred mostly in the pelvic region or lung. Conclusion: From our findings and a review of other reports, the FIGO stage is associated with survival, although other factors discussed in the literature are controversial. Some factors had been reported to have significant association only within a restricted histological subgroup. However, due to the limitation of our number of cases in each subgroup, we could not make such an analysis. Future studies with adequate numbers of samples are recommended.