Survival outcomes and prognostic factors of undifferentiated uterine sarcoma

Abstract Purpose Here, we aimed to describe the behavior of patients with undifferentiated uterine sarcoma (UUS) at our institution. Methods 29 patients with UUS who were treated at our institution between 2001 and 2020 were analyzed. Results The median age at diagnosis was 52 years (range: 26-70 years). The FIGO 2009 distribution by stage was as follows: stage I, 17 patients (58.6%); stage II, 5 patients (17.2%); stage III, 4 patients (13.8%); and stage IV, 3 patients (10.3%). For 28 patients who underwent surgical treatment, 27 patients (96.4%) underwent total/sub-radical/radical hysterectomy combined bilateral salpingo-oophorectomy, 17 (58.6%) pelvic lymphadenectomy, 7 (24.1%) para-aortic lymphadenectomy and 8 (28.6%) patients underwent omentectomy. The median follow-up was 23.4 months. 18 patients (62.1%) died during follow up, and 13 patients (72.2%, 13/18) died within 2 years after diagnosis. Median progression-free survival (mPFS) and overall survival (mOS) were 15.5 and 27.4 months, respectively. 2-year and 5-year PFS were 40.3% and 26.9%. 2-year and 5-year OS were 54.0% and 36.5%. Stage-specific mPFS and mOS were as follows: stage I-II—17.7 and 35.5 months, stage III-IV—6.0 and 6.7 months. Multivariate analysis showed that omentectomy was an independent predictor of decreased PFS (HR 0.059, 95% CI 0.006-0.587, P = 0.016) and OS (HR 0.042, 95% CI 0.004-0.488, P = 0.011). Conclusion UUS are a rare group of tumors with an aggressive behavior and poor outcomes. The current study shows that omentectomy seems to have benefited patients.