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Gynecol Oncol. 1999 Aug;74(2):196-201.

Leiomyosarcoma of the uterus: a clinicopathologic multicenter study of 71 cases.

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  • 1Department of Gynecology and Obstetrics, University of Vienna Medical School, Graz, Austria.

Abstract

OBJECTIVE:

The aim of this study was to evaluate the behavior of uterine leiomyosarcomas in relation to their clinical and pathologic features and to identify possible prognostic factors.

METHODS:

Seventy-one patients with histologically proven uterine leiomyosarcoma were included in the analysis. Leiomyosarcomas were defined as uterine smooth-muscle tumors with five or more mitoses per 10 high-power fields and cytologic atypia. Cox proportional hazards regression model was used to identify independent prognostic factors.

RESULTS:

The median follow-up time was 108 months; 5-year overall survival rate was 65%. Evaluating the correlation between several clinicopathologic parameters, tumors with vascular space involvement had a statistically significantly higher stage than tumors without vasular space involvement (P = 0.015). In a univariate Cox model early tumor stage (P < 0.0001), age <50 years (P < 0.0001), low mitotic count (P = 0.05), and the absence of vascular space involvement (P < 0.0005) were associated with good prognosis. In a multivariate analysis age (P = 0.002), tumor stage (P = 0.004), vascular space involvement (P = 0.003), and mitotic count in stage I tumors (P = 0.002) were found to be independent parameters for good prognosis in patients with uterine leiomyosarcoma.

CONCLUSION:

Early tumor stage, age <50 years, and absence of vascular space involvement were independently associated with good prognosis. Mitotic count was detected to be a strong prognostic parameter in early tumor stage, but failed to act as an independent prognostic parameter in patients with tumor stage II-IV disease.

Copyright 1999 Academic Press.

PMID:
10419731
[PubMed - indexed for MEDLINE]
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