PROGNOSTIC FACTORS IN UTERINE SARCOMAS - RETROSPECTIVE STUDY OF 21 YEARS AT THE HOSPITAL-CLINIC-I-PROVINCIAL OF BARCELONA

BACKGROUND: Uterine sarcomas show low incidence and poor outcome despi te the treatment. The prognostic factors for the survival were determi ned in this study. PATIENTS AND METHODS: Thirty-nine females with sarc oma of the uterus have been studied retrospectively from January 1975 to December 1996. They were treated in the Gynecology and Radiation On cology Departments at Hospital Clinic i Provincial of Barcelona. Thirt y-seven patients had surgery, 22 radiotherapy and 4 chemotherapy. The influence on the disease-specific survival, disease-free survival, loc al relapse disease-free survival and metastasis disease-free survival from the following pronostic factors was studied: age, pathologic subt ype, miometrial invasion, mitosis, vascular and lymphatic invasion, tu mor size, stage, radiotherapy and local relapse. RESULTS: 1) The disea se-specific survival at 2 and 5 years was 51.5% and 42.5% respectively , and the disease-free survival at 2 and 5 years was 39%; the incidenc e of local and distant relapses-was 28 and 33%. 2) The multivariate an alysis showed that the overall survival and the disease free survival were affected by the vascular invasion (odds ratio [OR] 12 and 32.6, r espectively) and the local failure (OR = 3 and 25.5, respectively); th e only factor that affected the local relapse-free survival and metast asis free survival was the III and IV stages (OR = 5.6 in both cases). CONCLUSIONS: in uterine sarcomas, the vascular invasion and the local relapse were prognostic factors for overall survival and for disease- free survival. In stages III and IV there was a decrease in the local relapse-free survival and metastasis-free survival. A correlation betw een vascular invasion and advanced stages was found. The outcome of th e uterine sarcomas is poor, local and distant failure being responsibl e for this bad prognosis.