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Clinical Results in the Management of Patients with Uterine Sarcoma
Path. Res. Pract. 169, 200-201 (1980)
Short Communications
I. Universitats-Frauenklinik Miinchen
Clinical Results in the Management of Patients with Uterine Sarcoma K.
J.
LOHE,
J.
BALTZER, W. WOLF, R. KURZL and H. TSCHEBINER
Summary From 24 Patients which were treated for uterine sarcomas during 1970-1977, 10 patients had a leiomyosarcoma, 6 an endometrial stromal sarcoma, and 8 a mixed mesodermal sarcoma. Surgical treatment was performed in 15 cases, and in 13 cases was followed by postoperative radiation. Eight patients were treated primarily by combined radium and cobalt 60 radiation therapy. Seventeen of 24 patients under control died, 15 of these within one year after onset of therapy. Regarding the histological patterns of sarcomas, both mitotic activity and vascular invasion was without prognostic significance in subsequent outcome.
From 1970 to 197724 patients with uterine sarcoma were treated primarily at the First University Women's Clinic in Munich. Ten patients had leiomyosarcoma, 6 had endometrial stromal sarcoma, and 8 had mixed mesodermal sarcoma (7 homologous, 1 heterologous). The mean age of the patients was 62 years (13 to 78 years). Vaginal bleeding was the most frequent symptom in 17 of the 24 patients. Surgical management ist the preferred treatment in patients with uterine sarcoma. Thus, in 15 of the 24 patients an abdominal hysterectomy and bilateral salpingo-oophorectomy was performed. Postoperative radiation treatment was necessary in 13 cases. Eight inoperable patients were treated primarily with combined Radium and Cobalt 60 radiation therapy. One patient with advanced disease received drug therapy. She died after a short period of time. Considering the clinically expected tumor extent, including microscopic results of curettage, 22 patients showed involvement of the uterine corpus, 15 patients of the uterine cervix. Two patients had sarcomatous change of the cervix only. From the clinical point of view there was a presumed penetration
Clinical Results in the Management of Patients with Uterine Sarcoma . 201
of the parametrium in 7 cases. In 1 patient the tumor affected the vaginal wall, in another case the adnexa were involved. The microscopically proven tumor extent showed involvement of the uterine corpus in 13 of 15 cases, and involvement of the cervix in 6 cases. In 2 patients the only the cervix was invaded by sarcomatous masses. Three patients had metastases in the adnexa. The prognosis of patients suffering from uterine sarcoma is unfavourable. Seventeen of the 24 patients under control died. Among these are 15 patients who succombed within the first year of treatment. Only 2 patients survived more than 5 years. The correlation between microscopic pecularities of the tumor and the prognosis of the patients suffering from uterine sarcoma is of great interest. From our investigations we conclude that, considering the degree of tumor necrosis, mitotic activity, and evidence of vascular invasion, histologic tumor pecularities had no prognostic value. Received July 10, 1979 . Accepted October 21, 1979
Key words: Uterine sarcoma - Histopathology - Clinical extent - Therapy Prognosis Priv. Doz. Dr. K. J. Lohe, l. Universitiits-Frauenklinik, MaistraRe 11, 8000 Miinchen, FRG
Short Communications
I. Universitats-Frauenklinik Miinchen
Clinical Results in the Management of Patients with Uterine Sarcoma K.
J.
LOHE,
J.
BALTZER, W. WOLF, R. KURZL and H. TSCHEBINER
Summary From 24 Patients which were treated for uterine sarcomas during 1970-1977, 10 patients had a leiomyosarcoma, 6 an endometrial stromal sarcoma, and 8 a mixed mesodermal sarcoma. Surgical treatment was performed in 15 cases, and in 13 cases was followed by postoperative radiation. Eight patients were treated primarily by combined radium and cobalt 60 radiation therapy. Seventeen of 24 patients under control died, 15 of these within one year after onset of therapy. Regarding the histological patterns of sarcomas, both mitotic activity and vascular invasion was without prognostic significance in subsequent outcome.
From 1970 to 197724 patients with uterine sarcoma were treated primarily at the First University Women's Clinic in Munich. Ten patients had leiomyosarcoma, 6 had endometrial stromal sarcoma, and 8 had mixed mesodermal sarcoma (7 homologous, 1 heterologous). The mean age of the patients was 62 years (13 to 78 years). Vaginal bleeding was the most frequent symptom in 17 of the 24 patients. Surgical management ist the preferred treatment in patients with uterine sarcoma. Thus, in 15 of the 24 patients an abdominal hysterectomy and bilateral salpingo-oophorectomy was performed. Postoperative radiation treatment was necessary in 13 cases. Eight inoperable patients were treated primarily with combined Radium and Cobalt 60 radiation therapy. One patient with advanced disease received drug therapy. She died after a short period of time. Considering the clinically expected tumor extent, including microscopic results of curettage, 22 patients showed involvement of the uterine corpus, 15 patients of the uterine cervix. Two patients had sarcomatous change of the cervix only. From the clinical point of view there was a presumed penetration
Clinical Results in the Management of Patients with Uterine Sarcoma . 201
of the parametrium in 7 cases. In 1 patient the tumor affected the vaginal wall, in another case the adnexa were involved. The microscopically proven tumor extent showed involvement of the uterine corpus in 13 of 15 cases, and involvement of the cervix in 6 cases. In 2 patients the only the cervix was invaded by sarcomatous masses. Three patients had metastases in the adnexa. The prognosis of patients suffering from uterine sarcoma is unfavourable. Seventeen of the 24 patients under control died. Among these are 15 patients who succombed within the first year of treatment. Only 2 patients survived more than 5 years. The correlation between microscopic pecularities of the tumor and the prognosis of the patients suffering from uterine sarcoma is of great interest. From our investigations we conclude that, considering the degree of tumor necrosis, mitotic activity, and evidence of vascular invasion, histologic tumor pecularities had no prognostic value. Received July 10, 1979 . Accepted October 21, 1979
Key words: Uterine sarcoma - Histopathology - Clinical extent - Therapy Prognosis Priv. Doz. Dr. K. J. Lohe, l. Universitiits-Frauenklinik, MaistraRe 11, 8000 Miinchen, FRG