Uterine sarcomas are rare malignant tumors characterized by a great clinical and histopathological diversity. The aim of this work is to analyze the difficulties of diagnosis, therapeutic and prognosis posed by these tumors. Thirty-seven patients with uterine sarcoma, collected in the service Radiotherapy and Oncology, University Ibn Rochd of Casablanca between January 2000 and December 2007 were included in this study retrospective. The average patient age was 50 years (17-76). The bleeding was present in all patients, isolated in 54% of cases associated with pelvic pain in 24.6% and a mass abdomino-pelvic in seven patients. The average time of evolution was 10 months. The main histological type was found leiomyosarcoma. Twenty four patients in our series underwent total hysterectomy without annexial conservation. The surgery R0 was obtained in 43% of cases. The sarcomas were classified as stage IV in 51.4%. Adjuvant radiotherapy was indicated in 13 patients. After a mean of 20 months, half of patients evaluable presented a local relapse and/or metastatic, the third of cases were tumor progression while complete remission was maintained in 18.5% of cases. Uterine sarcomas are rare malignant mesenchymal tumor, which often occur in women after menopause. The main prognostic factors are hormonal status of the patient, stage clinical, histological type, histological grade and quality surgical excision. The management of uterine sarcomas is multidisciplinary, based mainly on surgery remains the only means of cure. Adjuvant radiotherapy allows decreased risk of local recurrence, with no impact on survival achieved at best 30% at 5 years. The role of chemotherapy remains confirm.
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