Prognostic factors in uterine sarcoma

• Published in: Best practice & research. Clinical obstetrics & gynaecology Vol. 25; no. 6; pp. 783 - 795
• Main Author: Gadducci, Angiolo
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.12.2011
• Subjects: adenosarcoma; Adenosarcoma - metabolism; Adenosarcoma - pathology; Age Factors; carcinosarcoma; Carcinosarcoma - metabolism; Carcinosarcoma - pathology; endometrial stromal sarcoma; Female; Humans; leiomyosarcoma; Leiomyosarcoma - metabolism; Leiomyosarcoma - pathology; Mitotic Index; Neoplasm Grading; Neoplasm Staging; Obstetrics and Gynecology; Prognosis; Sarcoma - metabolism; Sarcoma - pathology; Sarcoma, Endometrial Stromal - metabolism; Sarcoma, Endometrial Stromal - pathology; undifferentiated stromal sarcoma; Uterine Neoplasms - metabolism; Uterine Neoplasms - pathology; uterine sarcoma; leiomyosarcoma; endometrial stromal sarcoma; adenosarcoma; carcinosarcoma; uterine sarcoma; undifferentiated stromal sarcoma
• ISSN: 1521-6934; 1532-1932; 1532-1932
• DOI: 10.1016/j.bpobgyn.2011.06.002

Uterine sarcomas usually have an aggressive clinical behaviour, with great tendency to local and distant spread, with unfavourable clinical outcome, excluding endometrial stromal sarcomas and adenosarcoma. Tumour stage is the strongest prognostic factor for all uterine sarcomas, with 5-year survival of about 50–55% for stage I and 8–12% for more advanced stages. Multivariate analysis of some studies have shown that women with leiomyosarcoma have a poorer survival than those with carcinosarcoma. The key issues that will be discussed include the prognostic relevance of pathological and biological variables other than tumour stage in the different histological subtypes of uterine sarcoma. Immunomarkers for cell proliferation and apoptosis have been tested for the identification of tumours with different clinical behaviour, but they are still subject to research and are not currently used in clinical practice.