RESUMEN
BACKGROUND: Uterine sarcomas consist a heterogeneous group of mesenchymal gynecological malignancies with unclear therapeutic recommendations and unspecific but poor prognosis, since they usually metastasize and tend to recur very often, even in early stages. METHODS: We retrospectively analyzed all female patients with uterine sarcomas treated in our institution over the last 17 years. Clinico-pathological data, treatments and outcomes were recorded. Kaplan-Meier curves were plotted and time-to-event analyses were estimated using Cox regression. RESULTS: Data were retrieved from 61 women with a median age of 53 (range: 27-78) years, at diagnosis. Fifty-one patients were diagnosed with leiomyosarcoma (LMS), 3 with high grade endometrial stromal sarcoma (ESS), 5 with undifferentiated uterine sarcoma (UUS), 1 with Ewing sarcoma (ES) and 1 with Rhabdomyosarcoma (RS). 24 cases had stage I, 7 stage II, 14 stage III and 16 stage IV disease. Median disease-free survival (DFS) in adjuvant approach was 18.83 months, and median overall survival (OS) 31.07 months. High mitotic count (> 15 mitoses) was significantly associated with worse OS (P < 0.001) and worse DFS (P = 0.028). CONCLUSIONS: Mitotic count appears to be independent prognostic factor while further insights are needed to improve adjuvant and palliative treatment of uterine sarcomas.
Asunto(s)
Manejo de la Enfermedad , Rabdomiosarcoma/diagnóstico , Sarcoma Estromático Endometrial/diagnóstico , Sarcoma de Ewing/diagnóstico , Adulto , Anciano , Femenino , Grecia/epidemiología , Humanos , Persona de Mediana Edad , Índice Mitótico/métodos , Índice Mitótico/tendencias , Pronóstico , Estudios Retrospectivos , Rabdomiosarcoma/epidemiología , Rabdomiosarcoma/terapia , Sarcoma Estromático Endometrial/epidemiología , Sarcoma Estromático Endometrial/terapia , Sarcoma de Ewing/epidemiología , Sarcoma de Ewing/terapiaRESUMEN
INTRODUCCIÓN: Diversos estudios han demostrado el valor pronóstico de la técnica de la biopsia del ganglio centinela (BGC) y el índice mitótico (IM) en el melanoma. Sin embargo, la relación entre ambos factores no está bien establecida. OBJETIVOS: El objetivo principal del estudio es describir y analizar la relación entre el resultado de la BGC y el IM en los pacientes con melanoma atendidos en nuestro centro. MÉTODO: En total se incluyeron 139 pacientes en los que se realizó la BGC de forma consecutiva entre mayo de 2001 y mayo de 2009. La relación entre el IM y el resultado de la BGC se ha realizado mediante el test χ2 y el test exacto de Fischer. RESULTADOS: Se detectó una correlación no significativa entre estas 2 variables con p = 0,071. En el subgrupo de pacientes que tenían un espesor de Breslow entre 4 y 1 mm el resultado fue una asociación estadísticamente significativa entre el IM y el resultado de la BGC con p = 0,034. La odds ratio para tener un ganglio positivo teniendo un IM < 1 en este subgrupo es de 0,838 (IC 95%: 0,758-0,926). DISCUSIÓN: Nuestro resultado apoya la utilización del IM como factor predictivo del resultado de la BGC en melanomas de espesor intermedio y apoya la necesidad de estudiar la relación entre estos factores para melanomas finos y gruesos
BACKGROUND: The prognostic value of sentinel lymph node (SLN) biopsy findings and mitotic activity in melanoma has been confirmed in the literature, but the relation between them has not been well established. OBJECTIVES: The main objective was to describe and analyze the correlation between SLN biopsy results and the mitotic rate in patients treated for melanoma in our hospital. METHODS: A total of 139 consecutive patients who underwent SLN biopsy between May 2001 and May 2009 were included. The relation between the mitotic rate and SLN status was analyzed with the χ2 test and the Fisher exact test. RESULTS: The correlation between the 2 variables was nonsignificant (P =0.071) in the patient series overall, but a significant association was found in the subgroup of patients with tumors of Breslow thickness between 1 and 4 mm (P =0.034). The likelihood (odds ratio) of SLN positivity with a mitotic rate of less than 1 mitosis/mm2 in this subgroup was 0.838 (95% CI, 0.758-0.926). CONCLUSIONS: Our findings support use of the mitotic rate to predict SLN status in melanoma tumors of intermediate thickness. Our study also shows the need for further investigation of the relation between these 2 variables in thin and thick tumors