Pattern of recurrences in early-stage uterine sarcoma: a retrospective CTFStudy

This multicenter retrospective Italian study assessed 176 patients with FIG O stage I-II uterine sarcoma treated between 1980 and 1994. Histologically 90 patients had a leiomyosarcoma (LMS), 20 had a high grade endometrial str omal sarcoma (ESS), and 66 had a carcinosarcoma (malignant mixed mesodermal tumor, MMMT). Surgery was the initial therapy for all patients, whereas po stoperative treatment was given without well defined protocols. Of the pati ents with LMS, 35 (38.9%) had a relapse (pelvic in 14.3% of cases, distant in 65.7%, and both pelvic plus distant in 20.0%) after a median time of 16 months. Five-year disease- free survival (DFS) was 56%. Of the patients wit h ESS, 11 (55.0%) had a relapse (pelvic in 27.2% of cases, distant in 36.4% , and both pelvic plus distant in 36.4%) after a median time of 5 months. F ive-year DFS was 45%. Of the patients with MMMT, 25 (37.9%) had a relapse ( pelvic in 40.0% of cases, distant in 40.0%, and both pelvic plus distant in 20.0%) after a median time of 8 months. Five-year DFS was 56% for stage I and 31% for stage TT. The high incidence of distant recurrences seems to ju stify the clinical research for effective adjuvant chemotherapy regimens in patients with early stage, high-grade stage uterine sarcomas.