Types of uterine sarcomas diagnosed:
(1) leiomyosarcoma
(2) malignant mixed Mullerian tumor (MMMT)
(3) endometrial stromal sarcoma (ESS)
Low-grade endometrial sarcoma tended to have a good prognosis, while all of the other types were unfavorable.
Stages used:
(1) Stage I: uterus
(2) Stage II: uterus and cervix
(3) Stage III: confined to pelvis
(4) Stage IV: extrapelvic disease
Poor prognostic features for a uterine leiomyosarcoma:
(1) Stage III or IV
(2) mitotic count between 10 and 20 mitoses in 10 high power fields (x400)
where:
• A mitotic count > 20 per 10 hpf was associated with a better prognosis, possibly because patients were treated more aggressively and received adjuvant therapy.
Poor prognostic features for a malignant mixed Mullerian tumor (MMMT):
(1) higher stage (not defined, possibly Stage II or higher (see note)
(2) age > 60 years
Poor prognostic features for an endometrial stromal sarcoma:
(1) mitotic count > 10 mitoses in 10 high power fields (indicating high grade disease)
(2) higher stage (not defined, possibly Stage II or higher (see note)
(3) age > 50 years
where:
• The cutoff for stage for MMMT and ESS were not stated. According to page 1429, column 1, prognosis was better for Stage I vs other stages.
