Abstract
<jats:p>Background. Uterine sarcomas are rare malignant mesenchymal tumors characterized by an aggressive clinical course and unfavorable prognosis. Low incidence, marked histological heterogeneity, and the lack of systematized national registry data complicate the assessment of clinical and epidemiological characteristics, treatment outcomes, and the impact of concomitant somatic and endocrine disorders on disease prognosis. The purpose of the study was to evaluate the relationship between clinical-histological characteristics and the presence of overweight and obesity in patients with stage I–II uterine sarcoma. Materials and methods. A retrospective observational study included 107 patients with stage I–II uterine sarcoma who received specialized treatment between 2010 and 2023. Clinical and demographic characteristics, histological subtype and tumor grade, body mass index, overall and disease-free survival were evaluated. The control group consisted of 20 women with uterine leiomyoma without oncological pathology. Statistical processing was performed using descriptive statistics and odds ratio analysis with a 95% confidence interval. Results. Among newly diagnosed uterine sarcoma cases, stage I disease predominated (77.6 %), whereas stage II accounted for 22.4 %. The highest incidence was observed in women aged 40–59 years. Leiomyosarcoma was the predominant histological subtype across all groups, accounting for 68.4 to 100 % of cases, while endometrial stromal sarcoma was identified significantly less frequently. Most patients were overweight or obese, with the highest body mass index observed in patients receiving adjuvant therapy (45.70 ± 1.68 kg/m2), which was significantly higher than in the control group (p < 0.05). Laboratory analysis demonstrated a statistically significant reduction in hemoglobin levels in patients with stage II disease and those undergoing combined treatment. The comorbidity profile was dominated by cardiovascular and gastrointestinal diseases, while the prevalence of diabetes mellitus was low (1–3 %). Women of reproductive and perimenopausal age showed a trend toward higher five-year overall and disease-free survival rates (2.0–2.04-fold) compared to menopausal patients; however, these differences did not reach statistical significance (p > 0.05). Conclusions. Stage I–II uterine sarcomas are characterized by a predominance of leiomyosarcoma, a high prevalence of metabolic disorders, and a moderate level of comorbidity. Overweight and obesity may have clinical relevance when planning adjuvant therapy. Age-related characteristics may potentially influence prognosis, warranting further investigation. The high prevalence of obesity and metabolic disorders indicates a significant role of endocrine factors in shaping the clinical course of early-stage uterine sarcoma.</jats:p>