Prognostic factors of mesenchymal and mixed tumors of uterus


Authors: J. Špaček 1;  J. Laco 2;  J. Petera 3;  P. Jílek 4;  E. Křepinská 1;  A. Řezáč 1;  S. Štipl 1,2
Authors‘ workplace: Porodnická a gynekologická klinika, LF a FN, Hradec Králové, přednosta doc. MUDr. J. Tošner, CSc. 1;  Fingerlandův ústav patologie, LF a FN, Hradec Králové, přednosta prof. MUDr. A. Ryška, Ph. D. 2;  Onkologická klinika, LF a FN, Hradec Králové, přednosta prof. MUDr. J. Petera, Ph. D. 3;  Katedra biologických a lékařských věd, FAF UK, Praha, vedoucí PharmDr. P. Jílek, CSc. 4
Published in: Čes. Gynek.2009, 74, č. 4 s. 292-297
Category: Original Article

Overview

Objective:
Analysis of clinical and histopathological prognostic factors with emphasis on carcinosarcomas, leiomyosarcomas and endometrial sarcomas of uterus.

Subject:
Review.

Setting:
Department of Obstetrics and Gynaecology, Medical Faculty Hradec Králové, Charles University, Prague; The Fingerland Department of Pathology, Medical Faculty Hradec Králové, Charles University, Prague; Department of Clinical Oncology, Medical Faculty Hradec Králové, Charles University, Prague; Department of Biological and Medical Sciences, Faculty of Pharmacy, Hradec Králové; Charles University, Prague.

Subject and method:
Discussion about our experience and current evidence.

Conclusion:
Mesenchymal and mixed tumors of uterus are characterized by several prognostic factors as well. Except clinical prognostic variables, histopathological and molecular biological factors may play a role. The most important prognostic significance carry stage of disease, age and performance status of patient and sufficient therapy, especially surgery. In particular tumors some other prognostic factors are recognized. Except cases in really early stage of disease there is usually short interval between end of primary therapy and tumor recurrence. With the exception of endometrial stromal sarcoma, prognosis of these tumors remains very poor.

Key words:
sarcoma, prognostic factor, stage.


Sources

1. Al-Nafussi, A. Uterine smooth-muscle tumors: practical approach to diagnosis. Curr Diag Pathol, 2004, 10, p.140-156.

2. Ali, S., Wells, M. Mixed müllerian tumors of the uterine corpus: a review. Int J Gynecol Cancer, 1993, 3, p. 1-11.

3. Amant, F., Cadron, I., Fuso, L., et al. Endometrial carcinosarcomas have a different prognosis and pattern of spread compared to high-risk epithelial endometrial cancer. Gynecol Oncol, 2005, 98, p. 274-280.

4. Amant, F., Vergote, I., Moerman, P. The classification of a uterine sarcoma as „high-grade endometrial stromal sarcoma“ should be abandoned. Gynecol Oncol, 2004, 95, p. 412-413.

5. Bell, SW., Kempson, RL., Hendrickson MR. Problematic uterine smooth muscle neoplasms. A clinicopathologic study of 213 cases. Am J Surg Pathol, 1994, 18, p. 535-558.

6. Berchuck, A., Rubin, SC., Hoskins, WJ., et al. Treatment of endometrial stromal tumors. Gynecol Oncol, 1990, 36, p. 60-65.

7. Brooks, SE., Zhan, M., Cote, T., Baquet, CR. Surveillance, epidemiology and results analysis of 2677 cases of uterine sarcoma 1989-1999. Gynecol Oncol, 2004, 93, p. 204-208.

8. Falconi, M., Crippa, S., Sargenti, M., et al. Pancreatic metastasis from leiomyosarcoma of the broad ligament of the uterus. Lancet Oncol, 2006, 7, p. 94-95.

9. Freitag, P. Rizikové a prognostické faktory gynekologických zhoubných nádorů. Mod Gynekol Porod, 2007, 16, p. 488-497.

10. Gadducci, A., Landoni F., Sartori, E., et al. Uterine leiomyosarcoma: analysis of treatment failures and survival. Gynecol Oncol, 1996, 62, p. 25-32.

11. Gadducci, A., Sartori, E., Landoni, F., et al. Endometrial stromal sarcoma: analysis of treatment failures and survival. Gynecol Oncol, 1996, 63, p. 247-253.

12. Harlow, BL., Weiss, NS., Lofton, S. The epidemiology of sarcomas of the uterus. J Natl Cancer Inst, 1986, 76, p. 399-402.

13. Inayama, Y., Shoji, A., Odagiri, S., et al. Detection of pulmonary metastasis of low grade endometrial stromal sarcoma 25 years afer hysterectomy. Pathol Res Pract, 2000, 196, p. 129-134.

14. Iwamoto, I., Fujino T., Higashi, Y., et al. Metastasis of uterine leiomyosarcoma to the pancreas. J Obstet Gynaecol Res, 2005, 31, p. 531-534.

15. Jonson, AL., Bliss, RL., Truskinovsky, A., et al. Clinical features and outcomes of uterine and ovarian carcinosarcoma. Gynecol Oncol, 2006, 100, p. 561-564.

16. Kurman, RJ. Blaustein’s Pathology of the Female Genital Tract. Fifth Edition. New York, Berlin, Heidelberg: Springer-Verlag, 2002.

17. Leath, CA, Huh, WK., Hyde, J., et al. A multi-institutional review of outcomes of endometrial stromal sarcoma. Gynecol Oncol, 2007, 105, p. 630-634.

18. Leibson, S., d’Ablaing, G., Mishell, DR., Schlaerth, JB. Leiomyosarcoma in a series of hysterectomies performed for presumed uterine leiomyomas. Am J Obstet Gynecol, 1990, 162, p. 968-976.

19. Major, FJ., Blessing, JA., Silverberg, SG., et al. Prognostic factors in early-stage uterine sarcoma. A Gynecologic Oncology Group study. Cancer, 1993, 71 (Suppl.4), p. 1702-1709.

20. McCluggage, WG. Uterine carcinosarcomas (malignant mixed Müllerian tumors) are metaplastic carcinomas. Int J Gynecol Cancer, 2002, 12, p. 687-690.

21. Moinfar, F., Azoli, M., Tavassoli, FA. Uterine sarcomas. Patology, 2007, 39, p. 55-71.

22. Nordal, RR., Kristensen, GB., Kaern, J., et al. The prognostic significance of stage, tumor size, cellular atypia and DNA ploidy in uterine leiomyosarcoma. Acta Oncol, 1995, 34, p. 797-802.

23. Nordal, RR., Thoresen, SO. Uterine sarcomas in Norway 1956-1992; incidence, survival and mortality. Eur J Cancer, 1997, 33, p. 907-911.

24. Oliva, E., Clement, P., Young, RH. Endometrial stromal tumors: an update on a group of tumors with a protean phenotype. Adv Anat Pathol, 2000, 7, p. 257-281.

25. Ptáčková, B., Krejčí, E. Sarkomy dělohy. Léčba a prognostické faktory. Gynekolog, 2000, 9, p. 215-218.

26. Reich, O., Winter, R., Regauer, S. Should lymphadenectomy be performed in patients with endometrial stromal sarcoma? Gynecol Oncol, 2005, 97, p. 982-983.

27. Riopel, J., Plante, M., Renaud, MC., et al. Lymph node metastases in low-grade endometrial stromal sarcoma. Gynecol Oncol, 2005, 96, p. 402-406.

28. Saiz, AD., Sachdev, U., Brodman, ML., et al. Metastatic uterine leiomyosarcoma presenting as a primary sarcoma of the parotid gland. Obstet Gynecol, 1998, 92, p. 667-668.

29. Salazar, OM., Dunne, ME. The role of radiation therapy in the management of uterine sarcomas. Int J Radiat Oncol Biol Phys, 1980, 6, p. 899-902.

30. Sartori, E., Bazzurini, L., Gadducci, A., et al. Carcinosarcoma of the uterus: a clinicopathological multicenter CTF study. Gynecol Oncol, 1997, 67, p. 70-75.

31. Silverberg, SV., Major, FJ., Blessing, JA., et al. Carcinosarcoma (malignant mixed mesodermal tumor) of the uterus. A Gynecologic Oncology Group pathologic study. Int J Gynecol Pathol, 1990, 9, p. 1-19.

32. Tavassoli, FA., Devilee, P. eds. WHO Classification of Tumours. Pathology and Genetics. Tumours of the Breast and Female Genital Organs. Lyon: IARCPress, 2003, p. 217-257.

33. Temkin, SM., Hellmann, M., Lee, YC., et al. Early-stage carcinosarcoma of the uterus: the significance of lymph node count. Int J Gynecol Cancer, 2007, 17, p. 215-219.

34. Uchino, M., Endo, G., Shibata, I., et al. Uterine leiomyosarcoma metastasis to the skull-case report. Neurol Med Chir, 1996, 36, p. 469-471.

35. Vaidya, AP., Horowitz, NS., Oliva, E., et al. Uterine malignant mixed müllerian tumors should not be included in studies of endometrial carcinoma. Gynecol Oncol, 2006,103, p. 684-687.

36. Wilkinson, N., Rollason, TP. Recent advanced in the pathology of smooth muscle tumours of the uterus. Histopathology, 2001, 39, p. 331-341.

37. Yokoyama, Y., Ono, Y., Sakamoto, T., et al. Asymptomatic intracardiac metastasis from a low-grade endometrial stromal sarcoma with successful surgical resection. Gynecol Oncol, 2004, 92, p. 999-1001.

38. Zaloudek, C., Hendrickson, MR. Mesenchymal tumors of the uterus. In: Kurman, RJ., ed. Blausteinęs pathology of the female genital tract. New York: Springer-Verlag Inc, 2002. p. 561-615.

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Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine
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