OBJECTIVE: To describe the natural history, prognostic factors, and optimal treatment modalities of undifferentiated endometrial sarcoma (UES). METHODS: A retrospective review was conducted of 30 patients with UES treated at Institut Gustave-Roussy, France, between January 1978 and December 2008. Clinical and pathologic variables, treatment modalities, and outcomes were assessed. RESULTS: Disease was advanced in most cases: FIGO stage III-IV in 70% of patients. Overall, 29 patients (96.7%) underwent hysterectomy as part of the initial surgical treatment; however, only 18 (60.0%) attained complete macroscopic resection. The incidence of pelvic and/or para-aortic lymph-node involvement at primary surgery or first recurrence was 44.4%. Median postoperative follow-up was 5 years; progression-free survival (PFS) and overall survival (OS) were 9.7 and 23 months, respectively. No differences in OS and PFS were observed by staging subgroup (FIGO vs the American Joint Committee on Cancer). Only postoperative pelvic radiotherapy with or without brachytherapy correlated with improved PFS (19.1 vs 6.5 months; P=0.04) and OS (54.5 vs 16.7 months; P=0.01) in a univariate analysis. CONCLUSION: Neither staging system was optimal for risk stratification. Multimodal therapy was recommended after surgery.
OBJECTIVE: To describe the natural history, prognostic factors, and optimal treatment modalities of undifferentiated endometrial sarcoma (UES). METHODS: A retrospective review was conducted of 30 patients with UES treated at Institut Gustave-Roussy, France, between January 1978 and December 2008. Clinical and pathologic variables, treatment modalities, and outcomes were assessed. RESULTS: Disease was advanced in most cases: FIGO stage III-IV in 70% of patients. Overall, 29 patients (96.7%) underwent hysterectomy as part of the initial surgical treatment; however, only 18 (60.0%) attained complete macroscopic resection. The incidence of pelvic and/or para-aortic lymph-node involvement at primary surgery or first recurrence was 44.4%. Median postoperative follow-up was 5 years; progression-free survival (PFS) and overall survival (OS) were 9.7 and 23 months, respectively. No differences in OS and PFS were observed by staging subgroup (FIGO vs the American Joint Committee on Cancer). Only postoperative pelvic radiotherapy with or without brachytherapy correlated with improved PFS (19.1 vs 6.5 months; P=0.04) and OS (54.5 vs 16.7 months; P=0.01) in a univariate analysis. CONCLUSION: Neither staging system was optimal for risk stratification. Multimodal therapy was recommended after surgery.
Authors: D Denschlag; F C Thiel; S Ackermann; P Harter; I Juhasz-Boess; P Mallmann; H-G Strauss; U Ulrich; L-C Horn; D Schmidt; D Vordermark; T Vogl; P Reichardt; P Gaß; M Gebhardt; M W Beckmann Journal: Geburtshilfe Frauenheilkd Date: 2015-10 Impact factor: 2.915
Authors: Dominik Denschlag; Sven Ackermann; Marco Johannes Battista; Wolfgang Cremer; Gerlinde Egerer; Markus Follmann; Heidemarie Haas; Philipp Harter; Simone Hettmer; Lars-Christian Horn; Ingolf Juhasz-Boess; Karin Kast; Günter Köhler; Thomas Kröncke; Katja Lindel; Peter Mallmann; Regine Meyer-Steinacker; Alexander Mustea; Edgar Petru; Peter Reichardt; Dietmar Schmidt; Hans-Georg Strauss; Clemens Tempfer; Falk Thiel; Uwe Ulrich; Thomas Vogl; Dirk Vordermark; Paul Gass; Matthias W Beckmann Journal: Geburtshilfe Frauenheilkd Date: 2019-10-22 Impact factor: 2.915