Uterine Sarcomas in Ramathibodi Hospital (1987-1998)

Abstract

Objective to study the incidence, clinical characteristics, treatment and outcome of patients with uterine sarcomas in Ramathibodi Hospital.

Subjects Twenty-six patients with uterine sarcomas who were diagnosed and treated in Ramathibodi Hospital from January 1987 to December 1998.

Results Twenty-six uterine sarcomas out of 346 uterine malignancies admitted (7.5%) were found during 12 - year period. The mean age was 45.1 years ( range 15 - 70 years ), with the mean parity of 2.9 (range 0-9). Nine patients ( 34.6 % ) were post-menopausal. The most common presenting symptoms was abnormal uterine bleeding (65.4 % ). Only 30.8 % of the cases could be diagnosed preoperatively. Fourteen patients had leiomyosarcomas, 5 patients had malignant mixed mesodermal tumors, 4 patients had high-grade endometrial stromal sarcomas and 3 patients had low-grade endometrial stromal sarcomas. The distribution by FIGO staging was as follows: stage 1: 73.1 %, none in stage II, stage III: 11.5%, stage IV: 15.4 %. The treatment was mainly hysterectomy, with either post-operative radiation or chemotherapy in advanced stager of the disease. The median follow-up time was 22 months. The five-year survival rate was 61.7 %.

Conclusions The incidence of uterine sarcoma in Ramathibodi Hospital is 7.5 % of uterine malignancy patients, or 10.7/10,000 gynecologic admissions. The most common histology was leiomyosarcoma ( 53.9 %). The most frequent presenting symptoms were uterine bleeding and abdominal mass. Treatment modalities were surgery, combined with chemo/radiotherapy in selected cases. The five-year survival rate of the whole group was 61.7 %.