[Clinical study and treatment of uterine sarcoma at Niigata City General Hospital].

We report a retrospective study of 16 patients with uterine sarcoma from 1986 to 2001 in Niigata City General Hospital. Five-year survival rates in stage I, II, III and IV (FIGO) were 68% (n = 4), 50% (n = 2), 0% (n = 3), and 0% (n = 7), respectively. Overall survival for the patients with incomplete resection of tumor at primary laparotomy (n = 7) was significantly poorer than that with complete resection (n = 8). Patients with a high-LDH (lactic acid dehydrogenase) value tended to have poorer prognoses, but there was no significant difference of overall survival between the high-LDH group (n = 8) and the normal-LDH group (n = 8). Fifteen patients had postsurgical adjuvant chemotherapy. Out of 5 evaluable patients undergoing first-line chemotherapy, there were only 2 partial responders with IAP (ifosfamide, adriamycin, cisplatin) chemotherapy, and out of 11 evaluable patients undergoing second-line chemotherapy, there was only 1 partial responder with IAP. Out of 10 patients who had no evidence of disease after prior therapy, 6 patients had recurrences. Five patients underwent secondary surgery for recurrence and residual tumor. Of them, 3 patients did not have complete resection of residual tumor and died within 1 year after secondary surgery. Although prognosis of advanced uterine sarcoma and recurrence is poor, it is suggested that aggressive resection for recurrence and residual tumor improves prognosis.