[Clinical aspects of uterine sarcomas (author's transl)].

Uterine sarcomas constitute 1% to 3% of all uterine cancers. There are three main histological varieties: endometrial stromal sarcoma, leiomyosarcoma, and mixed mesodermal (Müllerian) sarcoma. The tumors are characterized by local aggressiveness and early dissemination. According to the literature, 5 year survival rates range from 3 to 75% (!). This wide range reflects great prognostic differences in the various histologic types. On the other hand it may be due to discrepancies in histopathological evaluation. Radical surgery is the most effective therapy. In early stages it leads to 5 year survival rates of up to 88%. Adjuvant irradiation may increase the control of disease in the pelvis but has proven to be of little influence on the final outcome. The histologic variants show great differences in radiosensitivity. In endometrial stromal sarcomas adjuvant radiation therapy apparently can improve the treatment results. By contrast mixed mesodermal sarcomas are highly radioresistent. There is poor knowledge on the effectiveness of cytotoxic agents on uterine sarcomas. Objective remission of distant metastasis has been observed following treatment with cytotoxic antibiotics (Adriamycin).