Prognostic Factors and Role of Pelvic Lymphadenectomy in Patients with Uterine Sarcoma: A Multi-Center Population-Based Cohort Study.

Objective: The prognostic factors and impact of pelvic lymphadenectomy in uterine sarcomas remain unclear. This study aimed to investigate the prognostic factors and role of pelvic lymphadenectomy in uterine sarcoma.

Methods: We analyzed the data of uterine sarcoma patients obtained from 17 centers through the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2021. After propensity score matching analysis, the characteristics of the patients who underwent pelvic lymphadenectomy and those who did not were compared. Univariate and multivariate analyses were performed on patient data before and after propensity score matching. Additionally, survival analyses were performed for different subgroups.

Results: Multivariate COX regression analysis revealed that age, histology, tumor grade, and AJCC stage were correlated with prognosis (p < 0.001). Kaplan-Meier survival curve analysis showed that there was no significant difference in survival between the pelvic lymphadenectomy and non-pelvic lymphadenectomy groups (p=0.431). No statistically significant differences were observed in any of the subgroups analyzed, including age, histology, tumor size, tumor grade, stage, and marital status (p > 0.05).

Conclusion: Patient age, histological type, grade, and stage were significantly associated with the prognosis of uterine sarcoma. Additionally, pelvic lymphadenectomy did not confer a survival benefit to patients with this disease.