IMPACT OF MORPHOLOGICAL AND IMMUNOHISTOCHEMICAL PROGNOSTIC FACTORS ON TREATMENT OUTCOMES IN PATIENTS WITH STAGE I–II UTERINE SARCOMA
DOI:
https://doi.org/10.15407/oncology.2025.03.202Keywords:
uterine sarcoma, prognosis, Ki-67, estrogen receptors, progesterone receptors, adjuvant therapyAbstract
Summary. Aim: to improve treatment outcomes in stage I–II uterine sarcoma through individualized adjuvant therapy. Object and methods: a retrospective analysis of medical records, morphological preparations, and immunohistochemical studies of 107 patients with stage I–II uterine sarcoma was performed. Clinical data (age, stage, treatment regimen), morphological parameters (tumor type, nuclear atypia, presence of necrosis, lymphovascular invasion, number of mitoses) and immunohistochemical (IHC) markers (Ki-67, ER, PR) were studied. Overall and disease-free survival were assessed. Results: The obtained results demonstrate the key role of morphological and IHC factors in predicting the course of uterine sarcoma. Based on the obtained results, an algorithm for individualizing adjuvant therapy for patients with uterine sarcoma of stages I–II was developed, which is based on a comprehensive assessment of the degree of differentiation, indicators of mitotic activity, nuclear atypia, the presence of fields of necrosis, lymphovascular invasion and IHC profile (RE, RP, Ki-67). In the presence of ≥ 2 negative prognostic factors, it is recommended to use adjuvant therapy. Conclusions: individualized treatment improves outcomes and reduces recurrence risk.
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