Objectives To investigate the clinicopathological characteristics and prognosis of patients diagnosed with primary sarcoma of the uterine cervix. Methods We identified all patients with primary cervical sarcomas treated at our institution from 2002 to 2020. Clinical and pathologic variables, treatment modalities, and prognosis were abstracted from the medical records. Results Thirty-four patients were identified. Of these patients, 7 (20.6%) patients had leiomyosarcoma, 6 (17.6%) patients had

more »

... rcinosarcoma or malignant mixed Müllerian tumor, 5 ( 14.7% ) patients had Ewing's sarcoma, 4 (11.8%) patients had rhabdomyosarcoma , 4 (11.8%) patients had undifferentiated sarcoma, 3 (8.8%) patients had sarcoma not otherwise specified, 2 (5.9%) patients had adenosarcoma, 2 (5.9%) patients had endometrial stromal sarcoma, and 1 (2.9%) patient had alveolar soft tissue sarcoma. The median age of the whole patients was 43.5 years (range, 13-63). The median age of patients with Ewing's sarcoma or rhabdomyosarcoma was 22 years (range, 13-39) and 17 years (range, 13-36), respectively. Twenty-four patients presented with vaginal bleeding which was the most common primary symptoms. The 2018 distribution by stage was: stage I in 21 (61.8%) patients, stage II in 4 (11.8%) patients, stage III in 6 (17.6%) patients and stage IV in 3 (8.8%) patients. Overall, 30 patients (88.2%) received surgical treatment and 4 patients (11.8%) with advanced disease received systematic chemotherapy with or without radiotherapy. The median follow-up was 33.3 months (range 3.6–187.3 months). 15 patients died during follow up, and 11 patients died within 2 years after diagnosis, most of them were patients with carcinosarcoma or undifferentiated sarcoma (45.5%, 5/11). In the entire cohort, 2-year overall survival (OS) and 5-year OS were 67.2% and 56.9%, respectively. For patients with different pathologic subtype, 5-year OS was 25.0% for undifferentiated sarcoma, 50.0% for rhabdomyosarcoma, 50.0% for carcinosarcoma, 53.3% for Ewing's sarcoma, 57.1% for leiomyosarcoma, and 75.0% for others. The 5-year OS for stage I-II and III-IV patients were 62.3% and 41.7%, respectively. Conclusions Cervical sarcomas are rare neoplasms with multiple histological subtypes and follow an aggressive course. Surgery is the main treatment for cervical sarcoma. Prognosis may be associated with tumor histology and stage.