Background: This study aims to analyse the clinicopathological features of uterine sarcoma (US) and its impact on the survival outcomes.

Methods: This is a retrospective observational study including 85 patients of histologically proven US, surgically treated during the period of January 2010 to December 2019. The patients were staged according to the FIGO staging system. Surgery was the mainstay of management with adjuvant treatment administered based on the stage and histopathological subtype. Descriptive analysis of the sociodemographic and clinicopathological features was done and survival analysis was done using Kaplan-Meier method.

Results: The mean age of presentation in our study was 50.8 years for uterine leiomyosarcoma (ULMS), 45.5 years for low grade endometrial stromal sarcoma (LGESS), 48.1 years for high grade endometrial stromal sarcoma (HGESS) and 49.6 years in the OTHERS group. The majority were diagnosed in stage I (ULMS = 37.6%, LGESS = 16.5%, HGESS = 4.7%; OTHERS = 4.7%). The overall recurrence rate was 56.5%. 5-year overall survival (OS) and disease-free survival (DFS) rate of adenosarcoma (AS) was 100%, respectively. LGESS showed a 5-year OS and DFS rate of 86.3% and 60.5%, respectively. The 5-year OS and DFS rate of ULMS was calculated to be 77.7% and 39.9%, respectively. The 3-year OS and DFS of HGESS has been calculated to be 58.3% and 22.2%, respectively. Significance of serum lactate dehydrogenase value, stage of the tumour and the nature of adjuvant treatment were demonstrated for recurrence.

Conclusion: US tend to recur. However, AS and LGESS show better survival outcomes as per our study. A proper workup with intervention including appropriate adjuvant treatment would help to mitigate the severity of the disease.