To investigate the role of volume doubling time (VDT) in differentiating uterine sarcoma and cellular leiomyoma.

Forty-two cases of uterine sarcoma and 117 cases of cellular leiomyoma (CL) confirmed by operative pathology at the First Affiliated Hospital of Wenzhou Medical University from January 1, 2000 to May 31, 2021 were reviewed. According to the pathological results, these 159 tumors were divided into two groups: sarcoma group and CL group. The age at surgery, number of lesions, previous history of myomectomy, number of ultrasound examinations, date of inspections, menopausal status, lesion size, and preoperative ultrasound diagnosis were recorded. The average VDT (aVDT) and the smallest VDT (sVDT) were calculated. Mann-Whitney U-test was used for comparisons of aVDT and sVDT between the sarcoma group and the CL group, and Wilcoxon signed-rank test was used for comparisons of aVDT and sVDT. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic efficiency of aVDT and sVDT for the differentiation of uterine sarcoma and CL.

The median aVDT and sVDT of the 159 lesions were 13.41 (8.27, 31.54) months and 9.30 (5.34, 22.19) months, respectively. The median sVDT was significantly smaller than the median aVDT (Z=-7.575, P＜0.001). The median aVDT and sVDT of uterine sarcoma were 8.49 (3.81, 21.39) months and 5.23 (2.37, 9.37) months, respectively. The median aVDT and sVDT of CL were 15.24 (9.44, 32.70) months and 10.80 (6.67, 23.18) months, respectively. The median aVDT and sVDT of uterine sarcoma were significantly shorter than those of CL (Z=-2.917, -4.259, P=0.004, <0.001, respectively). The optimal cutoff values of aVDT and sVDT for differentiating uterine sarcoma from cellular leiomyom were 6.61 months (AUC=0.652; sensitivity, 47.6%; specificity, 87.2%) and 7.03 months (AUC=7.03; sensitivity, 66.7%; specificity, 72.6% ), respectively.

aVDT and sVDT are helpful in differentiating uterine sarcoma and CL, and can provide information for therapy strategy and follow-up.