PRIMARY OVARIAN SARCOMA (REPORT OF FOUR CASES)

Primary ovarian sarcomas are rare malignancies with a poor prognosis and usually behave very aggressively. Primary ovarian sarcomas usually occurs in postmenopausal women. Over a twenty seven year period (1970-1997) four cases of primary ovarian sarcoma were managed at the our clinics. To review the epidemiology, prognostic factors, and treatment results related to primary ovarian sarcoma at our center, a retrospective chart review of all patients referred for ovarian cancer was carried out from 1970 to 1997. Cases with confirmed pathologic diagnosis of primary ovarian sarcomas were selected, forming the present study group. Total abdominal hysterectomy and bilateral salphingo-oophorectomy +/- omentectomy were performed in three patients and right Oophorectomy and left ovarian wedge resection were performed in one patient. AII four patients received postoperative adjuvant chemotherapy and pelvic radiotherapy. At the initially, three patients with primary ovarian sarcomas were treated with cisplatinum, doxorubicin, and cytoxan (PAC). The median age at presentation was 42.25 years. One patient had Fusiform cell sarcoma, one patient had leiomyosarcoma and two patients had mixed (carcinosarcomas) mullerian sarcomas. Two patients were Stage I A, one patient were stage IIA and one patient were stage IIIA. Survival analysis showed a median survival of 42.5 months among all patients after diagnosis. The mainstay of treatment is debulking surgery consisting of total abdominal hysterectomy, bilateral salpingo-oophorectomy and extirpation of tumor masses. The benefit of postoperative adjuvant chemotherapy and/or radiotherapy is still a subject of debate and has yet not been established. PAC chemotherapy appears effective and pelvic irradiation should be administrated to reduce pelvic recurrence in this disease.