open access

Vol 6, No 1 (2010)
Review paper
Published online: 2010-05-06
Get Citation

Uterine sarcomas

Krystyna Serkies, Jacek Jassem
Onkol. Prak. Klin 2010;6(1):7-13.

open access

Vol 6, No 1 (2010)
REVIEW ARTICLES
Published online: 2010-05-06

Abstract

Uterine sarcomas are rare tumours, with variuos histology and clinical outcome. They are associated with high potential to both local recurrence and distant metastases, and the outcome is generally poor. Since 2009 a new classification and FIGO staging system have been proposed, regarding three subtypes of uterine sarcomas. Surgery continues to be the cornerstone of therapy for sarcomas limited to the uterus. In patients with carcinosarcomas postoperative radiotherapy increases the local control. The role of postoperative radiotherapy in the treatment of other uterine sarcomas remains to be determined. High rate of distant metastases suggests potential role of systemic therapy. However, the benefit of postoperative chemotherapy and endocrine therapy in high-risk patients has not been confirmed in randomised studies. These methods, in addition to palliative radiotherapy and surgery are used in recurrent and advanced disease.

Abstract

Uterine sarcomas are rare tumours, with variuos histology and clinical outcome. They are associated with high potential to both local recurrence and distant metastases, and the outcome is generally poor. Since 2009 a new classification and FIGO staging system have been proposed, regarding three subtypes of uterine sarcomas. Surgery continues to be the cornerstone of therapy for sarcomas limited to the uterus. In patients with carcinosarcomas postoperative radiotherapy increases the local control. The role of postoperative radiotherapy in the treatment of other uterine sarcomas remains to be determined. High rate of distant metastases suggests potential role of systemic therapy. However, the benefit of postoperative chemotherapy and endocrine therapy in high-risk patients has not been confirmed in randomised studies. These methods, in addition to palliative radiotherapy and surgery are used in recurrent and advanced disease.
Get Citation

Keywords

uterine sarcomas; radiotherapy; chemotherapy; endocrine therapy

About this article
Title

Uterine sarcomas

Journal

Oncology in Clinical Practice

Issue

Vol 6, No 1 (2010)

Article type

Review paper

Pages

7-13

Published online

2010-05-06

Bibliographic record

Onkol. Prak. Klin 2010;6(1):7-13.

Keywords

uterine sarcomas
radiotherapy
chemotherapy
endocrine therapy

Authors

Krystyna Serkies
Jacek Jassem

References (23)
  1. McCluggage WG. Uterine carcinosarcomas (malignant mixed Mullerian tumors) are metaplastic carcinomas. Int J Gynecol Cancer. 2002; 12(6): 687–690.
  2. Prat J. FIGO staging for uterine sarcomas. Int J Gynaecol Obstet. 2009; 104(3): 177–178.
  3. Giuntoli II, Metzinger DS, DiMarco CS, et al. Retrospective review of 208 patients with leiomyosarcoma of the uterus: prognostic indicators, surgical management, and adjuvant therapy. Gynecol Oncol. 2003; 94: 191–196.
  4. Kapp DS, Shin JY, Chan JK. Prognostic factors and survival in 1396 patients with uterine leiomyosarcomas: emphasis on impact of lymphadenectomy and oophorectomy. Cancer. 2008; 112(4): 820–830.
  5. Major FJ, Blessing JA, Silverberg SG, et al. Prognostic factors in early-stage uterine sarcoma. A Gynecologic Oncology Group study. Cancer. 1993; 71(4 Suppl): 1702–1709.
  6. Shah JP, Bryant CS, Kumar S, et al. Lymphadenectomy and ovarian preservation in low-grade endometrial stromal sarcoma. Obstet Gynecol. 2008; 112(5): 1102–1108.
  7. Thomas MB, Keeney GL, Podratz KC, et al. Endometrial stromal sarcoma: treatment and patterns of recurrence. Int J Gynecol Cancer. 2009; 19(2): 253–256.
  8. Reich O, Regauer S. Hormonal therapy of endometrial stromal sarcoma. Current Opinion in Oncology. 2007; 19(4): 347–352.
  9. Pink D, Lindner T, Mrozek A, et al. Harm or benefit of hormonal treatment in metastatic low-grade endometrial stromal sarcoma: single center experience with 10 cases and review of the literature. Gynecol Oncol. 2006; 101(3): 464–469.
  10. FIGO staging for uterine sarcomas. International Journal of Gynecology & Obstetrics. 2009; 104(3): 179.
  11. Pecorelli S. Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. International Journal of Gynecology & Obstetrics. 2009; 105(2): 103–104.
  12. Reich O, Winter R, Regauer S. Should lymphadenectomy be performed in patients with endometrial stromal sarcoma? Gynecol Oncol. 2005; 97(3): 982–986.
  13. Reed NS, Mangioni C, Malmström H, et al. European Organisation for Research and Treatment of Cancer Gynaecological Cancer Group. Phase III randomised study to evaluate the role of adjuvant pelvic radiotherapy in the treatment of uterine sarcomas stages I and II: an European Organisation for Research and Treatment of Cancer Gynaecological Cancer Group Study (protocol 55874). Eur J Cancer. 2008; 44(6): 808–818.
  14. Hoffmann W, Schmandt S, Kortmann RD, et al. Radiotherapy in the treatment of uterine sarcomas. A retrospective analysis of 54 cases. Gynecol Obstet Invest. 1996; 42(1): 49–57.
  15. Weitmann H, Knocke T, Kucera H, et al. Radiation therapy in the treatment of endometrial stromal sarcoma. International Journal of Radiation Oncology*Biology*Physics. 2001; 49(3): 739–748.
  16. Wolfson AH, Brady MF, Rocereto T, et al. A gynecologic oncology group randomized phase III trial of whole abdominal irradiation (WAI) vs. cisplatin-ifosfamide and mesna (CIM) as post-surgical therapy in stage I-IV carcinosarcoma (CS) of the uterus. Gynecol Oncol. 2007; 107(2): 177–185.
  17. National Comprehensive Cancer Network (NCCN) 02.2009.
  18. Kanjeekal S, Chambers A, Fung MF, et al. Systemic therapy for advanced uterine sarcoma: a systematic review of the literature. Gynecol Oncol. 2005; 97(2): 624–637.
  19. Sutton G, Brunetto VL, Kilgore L, et al. A phase III trial of ifosfamide with or without cisplatin in carcinosarcoma of the uterus: A Gynecologic Oncology Group Study. Gynecol Oncol. 2000; 79(2): 147–153.
  20. Homesley HD, Filiaci V, Markman M, et al. Gynecologic Oncology Group. Phase III trial of ifosfamide with or without paclitaxel in advanced uterine carcinosarcoma: a Gynecologic Oncology Group Study. J Clin Oncol. 2007; 25(5): 526–531.
  21. Hensley ML, Blessing JA, Mannel R, et al. Fixed-dose rate gemcitabine plus docetaxel as first-line therapy for metastatic uterine leiomyosarcoma: a Gynecologic Oncology Group phase II trial. Gynecol Oncol. 2008; 109(3): 329–334.
  22. Hensley ML, Blessing JA, Degeest K, et al. Fixed-dose rate gemcitabine plus docetaxel as second-line therapy for metastatic uterine leiomyosarcoma: a Gynecologic Oncology Group phase II study. Gynecol Oncol. 2008; 109(3): 323–328.
  23. Dahhan T, Fons G, Buist MR, et al. The efficacy of hormonal treatment for residual or recurrent low-grade endometrial stromal sarcoma. A retrospective study. Eur J Obstet Gynecol Reprod Biol. 2009; 144(1): 80–84.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

Wydawcą serwisu jest  "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl