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Outcome and prognosis in uterine sarcoma and malignant mixed Mullerian tumor

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

There is low evidence regarding the optimal treatment in patients with uterine sarcomas and malignant mixed Mullerian tumors (MMMTs). This study provides an overview of experience at our center with patients diagnosed with uterine sarcoma and MMMT, in relation to the clinical management and outcome.

Methods

The medical records for 143 patients with low-grade endometrial stromal sarcoma (ESS), leiomyosarcoma (LMS), and high-grade (undifferentiated) endometrial sarcoma (UES) and MMMT were reviewed. All available clinical and pathological data were collected and analyzed. Putative prognostic factors were entered into a multivariate analysis using a Cox proportional hazards ratio model, and survival data were calculated.

Results

The 5-year overall survival rates were significantly different between patients with ESS, LMS, and UES and MMMT (86 vs. 40 vs. 57 vs. 45 %; P < 0.001). The multivariate analysis showed that the patients’ age, higher FIGO stage (III–IV), a history of smoking, prior pelvic radiation, diabetes, and residual tumor after surgery were associated with a poorer overall survival. Histological subtypes of LMS (HR 4.68; 95 % CI 1.35–16.17), UES (HR 1.21; 95 % CI 0.26–5.77) and MMMT (HR 1.63; 95 % CI 0.42–6.43) were also associated with a poorer overall survival than ESS (P = 0.008). Adjuvant therapies showed no associations with overall survival.

Conclusions

Adjuvant therapy has so far not shown any overall survival benefit, and the focus is therefore on primary surgery. In future studies, the entities should be investigated separately in relation to prognostic factors and effective therapeutic management.

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Authors and Affiliations

  1. Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich Alexander University of Erlangen–Nuremberg, Universitätsstrasse 21–23, 91054, Erlangen, Germany

    Stefanie Burghaus, Sonja Halmen, Paul Gass, Grit Mehlhorn, Michael G. Schrauder, Michael P. Lux, Stefan P. Renner, Matthias W. Beckmann, Alexander Hein & Falk C. Thiel

  2. ALB FILS KLINKEN GmbH, Goeppingen, Germany

    Falk C. Thiel

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  1. Stefanie Burghaus
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  2. Sonja Halmen
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Correspondence to Stefanie Burghaus.

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Burghaus, S., Halmen, S., Gass, P. et al. Outcome and prognosis in uterine sarcoma and malignant mixed Mullerian tumor. Arch Gynecol Obstet 294, 343–351 (2016). https://doi.org/10.1007/s00404-015-3993-6

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