Evaluating prognostic parameters in women with uterine leiomyosarcoma. A clinicopathologic study

OBJECTIVE: To evaluate the prognostic impact of different clinicopathologic parameters in patients with uterine leiomyosarcoma. STUDY DESIGN: Twenty-one patients with histologically proven uterine leiomyosarcoma were included in the analysis. Leiomyosarcomas were defined as uterine smooth muscle tumors with > or = 5 mitoses per 10 high-power fields and nuclear atypia and/or necrosis. RESULTS: The median follow-up time was 47 months; 5-year overall survival was 41%. A univariate Cox model revealed that early tumor stage (P = .00001), age at diagnosis < 50 years (P = .02), absence of vascular space involvement (P = .04), low myometrial invasion (P = .006) and low histologic grade (P = .04) were associated with lengthened overall survival. Adjuvant radiotherapy and/or chemotherapy (P = .1) did not influence overall survival. CONCLUSION: Early tumor stage, age at diagnosis < 50 years, absence of vascular space invasion, low myometrial invasion and low histologic grade were parameters of a good prognosis in women with uterine leiomyosarcoma. Adjuvant chemotherapy and/or radiotherapy showed no benefit in these patients.