INCIDENCE OF UTERINE SARCOMA IN IVANO-FRANKIVSK REGION
Uterine sarcoma (US) is a rare disease characterized by an aggressive course and poor prognosis, accounting for 3–7% of malignant neoplasms of the uterus.
The goal. Study the incidence of uterine sarcoma in Ivano-Frankivsk region and to analyze the clinical and morphological characteristics of the tumor.
Materials and methods. Our research is based on clinical observations at the Municipal Non-Profit Institution “Precarpathian Clinical Oncology Center of the Ivano-Frankivsk Regional Council” for the period from 2010 to 2021.
The results. The analyzed data showed that the number of patients with uterine sarcoma was: stage I – 51.61%, stage II – 25.8%, stage III – 6.45%, and stage IV – 16.15%. Special attention should be paid to the observation of 48 patients with stages I, II uterine sarcoma (pT1-2NOMO).
The peak incidence of uterine sarcoma in women is observed in the age group of 40-59 years (60.4%).
The most common histological type is leiomyosarcoma, which accounts for 66.67%. Due to the different pathogenesis of the development of mesenchymal tumors, their clinical characteristics also differ. Leiomyosarcoma of the uterus is most often detected in the age group of 40-59 years (43.75%), but for endometrial stromal sarcomas, the peak incidence falls on the age group of 50-81 years, and it is 22.9%.
In patients with leiomyosarcoma stage I, the distribution of histological grading is almost the same for G1, G2 – 28.1% and 25%. In stage II leiomyosarcoma, G2 prevails – 18.75%. For endometrial stromal sarcoma, in contrast to leiomyosarcoma, G3 prevails for stage I and II, which is 38% and 25%, respectively.
In most patients with uterine sarcoma, an unencumbered oncology history was observed. Indicators of tumor markers (CA125, REA) for most patients with stage I-II uterine leiomyosarcoma were normal, for 66.67%.
Conclusions. Most often, uterine sarcoma occurs in women of perimenopausal and menopausal age; the peak incidence of uterine leiomyosarcoma is in the age group of 40-59 years. The peak incidence in women with endometrial stromal sarcoma was observed in the age group of 50-81 years. Most cases are diagnosed at stage I of the disease, and the most common histological type of all uterine sarcomas is leiomyosarcoma. Endometrial stromal sarcoma is the second histological type of spreading, which in world practice demonstrates the advantage of detecting a low degree of malignancy G1-2. In our clinical study, in stages I-II, the frequency of detection, corresponding to the degree of tumor differentiation, G3 prevails. Among patients with stage I leiomyosarcoma, women with normal BMI prevailed (20.83%); with stage II, women with excess body weight and obesity (Class III) prevailed, which amounted to 25%. The majority of patients with stage I endometrial stromal sarcoma had excessive body weight, which amounted to 36.4%. Women with obesity of Class I predominated in stage II endometrial stromal sarcoma – 27.3%. Non-aggravated oncology history was characteristic for majority of patients with uterine sarcoma. 87.5% of women with stages I, II leiomyosarcoma and 73% of patients with stages I, II endometrial stromal sarcoma had non-aggravated oncology history. In most patients with uterine sarcoma and those who had more than three pregnancies, uterine leiomyoma in the anamnesis was found. Indicators CA125, CEA for most patients with leiomyosarcoma were normal.
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