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• W58442006 abstract "Uterine sarcomas often present diagnostic problems. In addition, the plethora of names for the same tumor or groups of tumors makes it difficult to correlate diagnostic and therapeutic data. We have proposed a modification of the classification of Ober that we think offers a simple, straightforward, histogenetically accurate terminology for this group of tumors. It also permits as detailed a subclassification of each group of tumors as now seems warranted. To test this classification and the available diagnostic criteria, the uterine sarcomas at Barnes Hospital in St. Louis have been evaluated. Leiomyoma and leiomyosarcoma can be accurately separated in most instances. Smooth muscle tumors that have invaded contiguous organs or blood vessels are malignant. If invasion is not present the mitotic rate is evaluated. Tumors with less than 5 mitoses per 10 high power fields (HPF) are benign. Those with higher mitotic counts are malignant. The prognosis for leiomyosarcomas with greater than 10 mitoses per 10 HPF is poor and metastases are frequent. The behavior of smooth muscle tumors with mitotic counts between 4 and 9 per 10 HPF is less certain, but some tumors with this level of mitotic activity will metastasize. Patients with malignant mixed Miillerian tumors of the homologous type that are small and not invasive or have invaded the myometrium only superficially may be cured by hysterectomy. If the tumors are large and highly invasive, the outlook is almost hopeless in spite of any form of therapy. Heterologous malignant mixed Miillerian tumors with chondrosarcoma as the heterologous element and without significant invasion may also be cured. In our series the presence of osteoid, bone, or rhabdomyoblasts indicated a highly malignant neoplasm with fatal outcome. All such tumors were large at the time of initial diagnosis. The infiltrating stromal tumors with mitotic counts of about 20 per 10 HPF all metastasized; those with 5 per 10 HPF or less have not metastasized or recurred after therapy. This provides a sharp dividing point between endolymphatic stromal myosis and endometrial stromal sarcoma. The behavior of tumors with mitotic counts of 6 to 20 per 10 HPF is unknown, but they may have a better prognosis than stromal tumors with higher counts." @default.
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• W58442006 title "Uterine sarcomas" @default.
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• W58442006 doi "https://doi.org/10.1016/s0046-8177(70)80071-5" @default.
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