Objective: To analyze the clinical features and factors affecting the prognosis of uterine sarcoma with different histological types.
Methods: One hundred and six cases with uterine sarcoma treated were analyzed retrospectively, among which there were 67 cases with leiomyosarcoma (63.2%), 23 with malignant endometrial interstitial sarcomas (21.7%), 16 with malignant Mullerian mixed tumor (15.1%). According to Union Internationale Contre le Cancer (UICC) staging, 70 cases were on stage I, 12 cases were on stage II, 19 cases belonged to stage III, and 5 cases belonged to stage IV.
Results: (1) The patients with leiomyosarcoma and endometrial interstitial sarcoma were relatively younger, the patients of them aged under 50 amounted to 70.1% (47/67) and 60.9% (14/23) respectively, and those aged under 40 amounted to 29.9% (20/67) and 39.1% (9/23) respectively. The patients usually manifested with abnormal vaginal bleeding (67.0%), palpable mass of lower abdomen (32.1%), vaginal discharge (27.4%), pain on lower abdomen (28.4%), symptoms of oppression (25.5%), and discomfort feeling (28.3%). (2) The rate of preoperative diagnosis was 65.9%, especially that of leiomyosarcoma was lowest (42.9%). (3) In treatment, 16.0% of patients was treated by hysterectomy; bilateral salpingo-oophorectomy and pelvic lymphadenectomy; 75.5% of them by hysterectomy and bilateral salpingo-oophorectomy; after operation, 74.5% of them were treated by chemotherapy, 11.3% by radiotherapy, 6.6% by additional progesterone. (4) The survival period of the patients was related to pathologic types and clinical stages and ages of the patients. The prognosis of the patients with leiomyosarcoma younger earlier stage was better.
Conclusions: The clinical symptom of uterine sarcoma is nonspecific (mostly abnormal vaginal bleeding) and the prognosis is poor. The patients with leiomyosarcoma are younger and have better prognosis, but the rate of preoperative diagnosis is low. The prognosis of uterine sarcoma is related to pathologic types, clinical stage and ages of the patients.