Prognosticators and the role of lymphadenectomy in uterine leiomyosarcomas.

Objective: To analyze prognostic factors, the role of lymphadenectomy and postoperative adjuvant treatments in patients with uterine leiomyosarcomas (LMS).

Study Design: Sixty-three patients with uterine LMS are retrospectively analyzed with respect to both DFS and OS.

Results: Multivariate DFS analysis revealed percentage necrosis to be the unique factor to be significant (median DFS was 3.31 years for <25% necrosis and 0.78 for >25% necrosis). Multivariate analysis revealed the mitotic counts to be the unique significant factor affecting the OS (median OS was 7.20 and 1.73 years, respectively, for patients with mitotic counts of 1-5 and >6; respectively). Median DFS was 2.51 years for patients who had undergone lymphadenectomy and 2.36 years for remaining who did not have a lymphadenectomy procedure (P = 0.4). With respect to OS, median values were 2.44 and 3.16 years, respectively (P = 0.7). Number of the resected lymph nodes was also not significant for both OS and DFS.

Conclusions: Mitotic counts and percentage necrosis have significant effects on OS and DFS; respectively. Neither the performance nor the extent of lymphadenectomy has an effect on patient survival.