Uterine sarcomas: The Curie Institut experience. Prognosis factors and adjuvant treatments

Purpose. With a retrospective study at a single institution, we propose to analyze the prognosis factors and adjuvant treatment for uterine sarcomas. Materials and Methods: From 1975 to 1995, 73 uterine sarcomas were treated at the Institut Curie, corresponding to 61 T1, 5 T2, and 8 T4 tumors. Thirt een patients had metastatic disease at the rime of diagnosis. The mean age was 58 years. In 71% of patients, the presenting sign was bleeding. This se ries consisted of 44% leiomyosarcomas (LIMS), 19% endometrial stromal sarco mas (ESS), and 31% carcinosarcomas or mixed mesodermal sarcomas (MMS). For the grading classification, we used the classification of the Sarcoma Group of the French Federation of Cancer Centres for soft tissue sarcomas. Of th e patients, 66% presented a high-grade tumor. Results. The median overall survival was 42 months, with a 5-year survival of 45%. Histological grade, FIGO stage, histology types, and menopausal sta tus were the four independent factors in multivariate analysis. Eighteen pa tients relapsed locally (25.7%), with 77% central pelvic sites. Patients wi th radiotherapy and ESS had better local control in multivariate analysis. Thirty-four patients developed metastases (48.6%), mainly pulmonary (58.8%) , Eight patients presented with peritoneal disease. High grades and LMS had the worst survival without metastasis in multivariate analysis. Conclusion: This study validated our classification for sarcoma grading and confirmed the finding of worst prognosis for LMS and the importance of rad iotherapy in local control. (C) 1999 Academic Press.