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A uterine sarcoma is a highly malignant type of cancer that forms from the uterine corpus.1 Uterine sarcomas comprise less than five per cent of uterine cancers, with risk factors similar to those for endometrial cancers. Sarcoma means a malignant tumour of connective or non-epithelial tissue.2–5
Types of uterine cancers
- Mixed mesodermal tumours – carcinosarcoma whereby the sarcoma is mixed with adenocarcinoma, previously known as malignant mixed mullerian tumour
- Leiomyosarcomas6
- Endometrial stromal tumours
Symptoms of uterine cancers
- Abnormal vaginal bleeding
- Sometimes pelvic pain
- Sometimes pelvic mass can be felt
Staging of uterine cancers
- Confined to the corpus
- Confined to the corpus and cervix
- Spread outside the uterus but confined to the pelvis
- Spread outside the true pelvis or into the mucosa of the bladder or rectum
Outcomes for uterine cancers
Prognosis of uterine cancers such as these sarcomas is reasonably poor, with stage one survival rates sitting at about 50 per cent, while stage four cancers had just a three per cent survival rate.7 These cancers typically recur in the uterus, abdomen and lungs.
Treatments for uterine cancer
Treatments typically involve a total hysterectomy, removal of the ovaries and fallopian tubes (salpingo-oophorectomy) or complete removal of all pelvic organs (pelvic exenteration).8,9 Radiation therapy delays recurrence, but doesn’t improve survival rates.
Chemotherapy may be used when tumours are recurrent or advanced, with the drug varying by tumour type.10 Chemotherapy isn’t very effective at increasing survival rates. Progestins may be effective for endometrial stromal tumours.
- Bessen T, Caughey GE, Shakib S, et al. A population-based study of soft tissue sarcoma incidence and survival in Australia: An analysis of 26,970 cases. Cancer Epidemiology. 2019;63:101590.
- Santos P, Cunha TM. Uterine sarcomas: clinical presentation and MRI features. Diagnostic and Interventional Radiology. 2015;21(1):4–9.
- Mbatani N, Olawaiye AB, Prat J. Uterine sarcomas. International Journal of Gynecology & Obstetrics. 2018;143(S2):51–58.
- Tropé CG, Abeler VM, Kristensen GB. Diagnosis and treatment of sarcoma of the uterus. A review. Acta Oncologica. 2012;51(6):694–705.
- Wu TI, Yen TC, Lai CH. Clinical presentation and diagnosis of uterine sarcoma, including imaging. Best Practice & Research Clinical Obstetrics & Gynaecology. 2011;25(6):681–689.
- Mao J, Pfeifer S, Zheng XE, Schlegel P, Sedrakyan A. Population-Based Estimates of the Prevalence of Uterine Sarcoma Among Patients With Leiomyomata Undergoing Surgical Treatment. JAMA Surgery. 2015;150(4):368.
- Tanner EJ, Garg K, Leitao MM, Soslow RA, Hensley ML. High grade undifferentiated uterine sarcoma: Surgery, treatment, and survival outcomes. Gynecologic Oncology. 2012;127(1):27–31.
- Kho KA, Lin K, Hechanova M, Richardson DL. Risk of Occult Uterine Sarcoma in Women Undergoing Hysterectomy for Benign Indications. Obstetrics & Gynecology. 2016;127(3):468–473.
- Lewis D, Liang A, Mason T, Ferriss JS. Current Treatment Options: Uterine Sarcoma. Current Treatment Options in Oncology. 2024;25(7):829–853.
- Shah SH, Jagannathan JP, Krajewski K, O???Regan KN, George S, Ramaiya NH. Uterine Sarcomas: Then and Now. American Journal of Roentgenology. 2012;199(1):213–223.
