We identified all patients with HGUS who received treatment at our institution from 1/2000 to 3/2011. Demographics, surgical procedures, disease stage, treatment response, and survival outcomes were abstracted from the medical records.
Twenty-one patients were identified. FIGO 2008 stage distribution was: I ¡ª 7 (33 % ), II ¡ª 1 (5 % ), III ¡ª 2 (10 % ), IV ¡ª 11 (52 % ). Eighteen of 21 patients (86 % ) undergoing primary surgical resection achieved a complete gross resection; however, progression within the abdominal cavity was identified in 11 patients (61 % ) by the time they underwent postoperative imaging. Of 13 patients who received first-line chemotherapy for measurable disease, the overall response rate was 62 % . Responses were observed in patients treated with gemcitabine/docetaxel (6 of 8) and doxorubicin-based regimens (2 of 5). Progression-free and overall survivals for the entire cohort were 7.3 months and 11.8 months, respectively. In 14 patients with measurable disease at the time of treatment, 1-year survival was 35.7 % versus 80 % in 5 patients without measurable disease at time of treatment (P = 0.112). Nine patients received second- or additional chemotherapy for progressive disease, with response rate of 19 % . Time to progression was short among responders.
HGUS represents a distinct histologic subtype of uterine sarcoma with poor outcomes regardless of stage at diagnosis. A majority rapidly develops distant metastases despite surgical resection. Gemcitabine-docetaxel and doxorubicin-based treatment achieved objective, but short-lived, responses in patients with measurable disease.