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Uterine sarcoma: 14 years experience in KCCC.

AIM OF THE WORK
To asses the profile, pattern of failure and survival for patients with uterine sarcoma seen in KCCC.


MATERIAL AND METHODS
A total of 23 records for patients with uterine sarcoma attending KCCC between July 1993 to May 2007 were available for review. The medical records were assessed for the profile of the disease, histological types, types of treatment, pattern of failure and survival. All cases were proven histologically. The majority of cases 15/23 (65.2%) were endometrial stromal sarcoma, 4/23 (17.4%) had leiomyosarcoma and 4/23 (17.4%) had carcinosarcoma. Twenty two out of 23 patients (95.6%) had surgery and 8/22 (36.4%) were given adjuvant post-operative pelvic radiotherapy. Three patients were treated with palliative intent by radiation. Five patients received palliative chemotherapy.


RESULTS
The mean age of all patients was 53.17+/-11.06 (range 34-80 years). The majority of patients 15/23 (65.2%) had stage I disease. High tumor grade was seen in 12/23 (52.2%) of patients. The pattern of failure was local in only 2 patients, systemic in 4 patients and both local and systemic in 5 patients. The overall DFS-5 years was 59.6%.The 5 y-DFS for patients treated by surgery & RT was 87.5% compared to 36.4% for those treated by surgery alone. Patients with early disease (stage I) had a 5 year DFS of 74% compared to 33.3% for those with advanced disease (stages III&IV). Patients with high grade tumors had a 5 year- DFS of 27% versus 100% for those with low grade tumors.


CONCLUSION
Stage and grade are important predictors of survival. Post-operative adjuvant pelvic irradiation is associated with improved 5-years DFS.