The comparison of 1988 and 2009 FIGO staging system for uterine sarcoma in King Chulalongkorn Memorial Hospital during 1999-2008

Backgrounds: Uterine sarcoma was staged previously according to the 1988 FIGO staging system for endometrial adenocarcinoma. However, in 2009 a new staging system for uterine sarcoma has been developed.

Objectives: The purpose of this study was to compare the survival between traditional and new FIGO staging system.

Materials and methods: The medical records of uterine sarcoma patients who received primary treatment at King Chulalongkorn Memorial Hospital, Thailand between 1999 and 2008 were reviewed. The survival curves were generated by Kaplan-Meier method. A comparison of survival between groups was assessed by the log-rank test.

Results: Thirty-three patients were included. The incidence of uterine sarcoma was 0.8% and 4.4% of all gynecologic cancers and uterine cancer, respectively. A comparison between these two staging systems showed that four patients (12.1%) were down-staged and none was up-staged. The 5-year disease-free survival (DFS) and overall survival (OS) were 40.4% and 56.0%, respectively. Age, parity, histology, tumor size, lymph node dissection, and adjuvant treatments were not significant prognostic factors. Patients with early stage had significantly longer survival than those with advanced stage. Mean DFS in early stage according to 1988 and 2009 FIGO staging system were 80 and 77 months, respectively. Mean OS were 97 months and 91 months, respectively. Mean DFS in advanced stage were 34 months and 15 months, respectively. Median OS were 12 months and 10 months, respectively. There was no difference in survival between these two staging systems.

Conclusions: Stage is the only independent prognostic factor. There was no difference in survival between these two staging systems.