Bilateral salpingo-oophorectomy in patients with uterine sarcoma: a multi-centre retrospective analysis

Objective: The aim of this study is to assess the effect of bilateral salpingo-oophorectomy (BSO) in patients with uterine sarcoma on recurrence rate and overall survival. Methods: Medical records of patients diagnosed with uterine sarcoma were reviewed. Survival rates and recurrence rates of patients with BSO and with ovarian preservation (OP) were calculated. Results: Fifty-one patients were included. Hysterectomy with BSO was performed in 21 patients (41%). Hysterectomy only, with OP was performed in 18 cases (35%). In 8 cases (17%) in addition to hysterectomy with BSO, a lymphadenectomy or debulking surgery was performed. The five-year overall survival rate (OS) for patients with OP was 78% and for patients with BSO only it was 52%. A Kaplan-Meier analysis showed a survival difference between patients with OP and patients with BSO, in favour of patients who had OP (log-rank P = 0.014). In the group of patients with FIGO stage 1&2, again a survival benefit was seen for patients who had OP (log-rank P = 0.020). The recurrence rate for patients with OP was 33% and 48% forpatientswith BSO(P = 0.366). Thefive-year OSforall patients with uterine sarcoma was 57% with a five-year recurrence of 33%. Conclusion: There is no significant decreased survival of patients who had OP surgery compared to patients who had BSO in case of uterine sarcoma. Primary ovarian sparing surgery can be considered for specific patients with uterine sarcoma.

Uterine sarcoma; Treatment; Bilateral salpingo-oophorectomy; Survival; Recurrence

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