[Sarcoma of the uterus. A clinical study apropos of 50 surgically treated cases at the Gustave Roussy Institute. Review of the literature].

From 1970 to 1987 fifty patients with uterine sarcoma who have been operated at the G. Roussy Institute (IGR) were studied. The histological material was reviewed according to the W.H.O. classification and the Hendrickson and Kempson's criteria. Staging was done on surgical and histological findings according to the pTNM classification of the UICC for endometrial carcinoma. There were 22 cases of heterologous malignant mixed müllerian tumor (MMT), 5 cases of homologous MMT, 20 cases of leiomyosarcoma (LS), 1 high grade stromal sarcoma, 1 low grade stromal sarcoma (stromal myosis (SM], 1 adenosarcoma. There were 22 cases of stage T1 T2, 23 cases of stage T3 T4 and 5 TX (first surgery outside IGR). Total hysterectomy with bilateral salpingo-oophorectomy was performed in 86% of the cases. Radiation therapy was performed in 26 cases mostly external pelvic irradiation associated with endobrachytherapy. "Cyvadic" combination chemotherapy was used in 16 cases associated with platinum in few cases. There were 2 postoperative deaths, 11 cases of progression and 37 cases of complete remission (CR). Of the 37 cases of CR, 10 patients are alive with NED 6 months to 10 years after diagnosis in 2 cases of MMT. 27 patients presented recurrence or metastasis. Of the 22 patients with pelvi-abdominal recurrence, 10 had debulking surgery (one total pelvic exenteration (PE), three posterior PE). Among them five are alive 14 to 78 months later (3 LS, 1 AS, 1 SM). Thirty percent of the patients developed lung metastasis. The overall five-year survival was 42 +/- 16% (28 patients) (Kaplan-Meier's method), similar to literature data.(ABSTRACT TRUNCATED AT 250 WORDS)