Clinical Characteristics, Prognostic Factors and Overall Survival of Patients with Uterine Sarcoma at King Chulalongkorn Memorial Hospital during 2002-2019
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Abstract
Objectives: The primary objective aimed to evaluate overall survival (OS) of patients with leiomyosarcoma (LMS), endometrial stromal sarcoma (ESS) and carcinosarcoma (CS) at King Chulalongkorn Memorial Hospital (KCMH) from 1st January 2002 to 31st December 2019. The secondary objectives were to identify disease-free survival (DFS), clinical characteristics, prognostic factors, and treatment modalities of LMS, ESS and CS treatments.
Materials and Methods: A retrospective study was conducted. Patients who were diagnosed with LMS, ESS or CS, received primary treatment at KCMH and had pathology specimens for review were recruited. Patients who had insufficient data were excluded. General characteristics, surgical treatment, prognostic factors, DFS and OS of patients were collected. Statistical analysis was performed by STATA version 14.1.
Results: One hundred and fourteen cases were reviewed. Thirteen cases were excluded due to incomplete data. OS at 2, 5, and 10 years of LMS group were 74.0%, 59.8%, and 41.9%; of ESS group were 80.8%, 80.8%, and 64.7%; and of CS group were 59.6%, 49.8%, and 49.8% respectively. Uterine weight of 400 grams or more had a significant effect on OS in CS group (hazard ratio (HR) 5.65, 95% confidence interval (Cl) 1.34-23.82, p = 0.018). Pelvic lymph node status had a significant effect on DFS in LMS group (HR 8.92, 95% CI 1.09-72.97, p = 0.041).
Conclusion: Only half of the LMS and CS patients survived up to 5 years but 80% of ESS survived more than 5 years. Uterine weight of 400 grams or more was the significant prognostic factor for OS in CS, while pelvic lymph node status was the significant prognostic factor for DFS in LMS.
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