ANALYSIS OF FACTORS INFLUENCING TREATMENT OUTCOMES OF UTERINE SARCOMAS.

Abstract

Background: Uterine sarcoma (US) is a rare type of tumor characterized by aggressive clinical behavior and high recurrence rate. Its histopathological heterogeneity has led to a lack of consensus regarding risk factors that could guide the selection of optimal treatment strategies for this pathology.

Aim: To investigate the factors influencing treatment outcomes of US.

Materials and methods: We conducted a retrospective analysis of the treatment outcomes of 107 women diagnosed with stage I-II US from 2010 to 2023. The follow-up period ranged from 1.0 to 156.0 months. Kaplan - Meier survival curves were used for the analysis of overall survival (OS) and recurrence-free survival (RFS) rates. The correlation between the studied parameters was analyzed including relative risk (odds ratio, OR) and correlation coefficient.

Results: The assessment of OR allowed us to identify the following prognostic factors with a negative impact on the 5-year OS and RFS of patients with US: differentiation grade G3, necrotic areas in tumor tissue, lymphovascular invasion, high mitotic activity (11 or more mitoses per 10 HPF), nuclear atypia 4+, negative ER and PR statuses, and high Ki-67 expression.

Conclusions: Survival of patients with US depends on tumor grade, necrosis, and lymphovascular invasion of tumor tissue; mitotic activity and nuclear atypia; ER and PR statuses; and the level of Ki67 expression.