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Uterine sarcomas in RIPAS Hospital, Brunei; a 10 year retrospective

study.Dr Alice Kurien, Dr Saw Ohnmar, Dr Hjh Roselina Yaakub.Department of Obstetrics & Gynaecology, RIPAS Hospital, Brunei Darussalam

Objectives

To evaluate :

Demographic profile Risk factors

Diagnostic issues

Clinical outcome

Methods

Results

Total cases of uterine corpus cancer -156Uterine Sarcoma - 37(23.7% ).

Conclusions

References

Higher proportion of uterine sarcoma among women with corpus cancer in Brunei .

Mean Age was 47.8 years

One or more risk factors in 78 % patients.

Multiple risk factors noted in 30%

63% are disease free after 5 years follow up.

70% are alive & well.

Disease stage was the most important prognostic factor.

Further research is required to identify the cause of higher incidence in the study population.

LOGO OPTIONAL

HERE

Yearly distributionYear 2001 02 03 04 05 06 07 08 09 10

No. 3 2 0 2 1 5 5 7 5 7

Parity distribution

Parity Number %

0 7 18.92

2-4 23 62.16

5& > 7 18.92

Menopausal status Number %

Pre menopausal 29 78.38

Post menopausal 8 21.62

Pre op Diagnosis Intra op Diagnosis Post op diagnosis

5 2 30

13.51% 5.41% 81.08 %

Histology Number %

Leiomyosarcoma (LMS)- Low grade

Carcinosarcoma(MMMT)

1

8

35.14

21.62

LMS -High grade

Endometrial stromal sarcoma

7

4

18.92

10.81

Endometrial Sarcoma (High grade)

Adenosarcoma

4

1

10.81

2.70

All patients with uterine

sarcoma registered in the

department of Obstetrics and

Gynaecology in RIPAS hospital

from 2001 to 2010 were

studied. Cases were identified

through the gynaecology

oncology registry of the

department. This was a

retrospective case file analysis.

The data was recorded in a pre-

designed proforma and a

detailed analysis was done.

Prior approval from Brunei

Darussalam Medical & Health

Research Ethics Committee was

obtained.

Symptom Number %

Abnormal uterine bleeding (AUB),Mass

Abdomen

11 29.73

Mass abdomen 10 27.03

AUB 9 24.32

AUB +Mass +pressure symptoms 2 5.41

AUB+ pain 2 5.41

AUB+ Mass +pain 1 2.7

Pain + Mass ,+pressure symptoms 1 2.7

Vaginal discharge + mass p/v 1 2.7

Stage Number Alive DiedI 26 26 NilII 2 2 NilIII 4 2 2 (50%)IV 5 1 4 (75%)

Age distribution

FIGO stage1. Vanessa N Harry et al. Review uterine sarcomas: The Obstetrician & Gynaecologist.2007; 9: 88-94.2 Jonathan S Berek, Neville F Hacker: Practical Gynecologic Oncology 4th edition.2005; 430-435.3. Michael Quinn et al: Malignant disease of the uterus. Shaw’s text book of gynecology th edition 644-8.4.McCluggage WG Uterine carcinosarcomas (malignant mixed mullerian tumors) are metaplastic carcinomas. Int J Gynecol Cancer.2002 Nov-Dec;12(6):687-905 .Kernochan LE,Garcia RL. Carcinosarcomas (malignant mixed mullerian tumor) of the uterus: advances in elucidation of biologic and clinical characteristics.

6. Zelmanowicz et al .Evidence for a common etiology for endometrial carcinoma and MMMT. Gynaecol Oncol 1998;69:253-2577. Norris HJ , Taylor HB. Post irradiation sarcomas of the uterus. Obstet Gynaecol1965; 26:689-693.8 Philip J. DiSaia, William T.Creasman. Clinical Gynecologic oncology.169-74.

Survival status

RISK FACTORS