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Review
. 2024 Jul;25(7):829-853.
doi: 10.1007/s11864-024-01214-3. Epub 2024 May 31.

Current Treatment Options: Uterine Sarcoma

Dana Lewis  1 , Angela Liang  1 , Terri Mason  2 , James Stuart Ferriss  3
Affiliations
Review

Current Treatment Options: Uterine Sarcoma

Dana Lewis et al. Curr Treat Options Oncol. 2024 Jul.

Abstract

The cornerstone of treatment for uterine sarcoma, regardless of histologic type, remains en bloc surgical resection with total hysterectomy. In the case of incidental diagnosis during another procedure, such as myomectomy, where a hysterectomy was not performed initially, completion hysterectomy or cervical remnant removal is recommended. The completion of additional surgical procedures, including bilateral salpingo-oophorectomy and lymphadenectomy, remains nuanced. Bilateral salpingo-oophorectomy remains controversial in the setting of most subtypes of uterine sarcoma, except in the case of hormone-receptor positivity, such as in low grade endometrial stromal sarcoma, where it is indicated as part of definitive surgical treatment. In the absence of apparent nodal involvement, we do not recommend performing universal lymphadenectomy for patients with sarcoma. We recommend systemic therapy for patients with extra-uterine or advanced stage disease, high-grade histology, and recurrence. The most active chemotherapy regimens for advanced, high-grade disease remain doxorubicin or gemcitabine and docetaxol combination therapy. A notable exception is low grade endometrial stromal sarcoma, where we recommend anti-hormonal therapy in the front-line setting. Radiation therapy is reserved for selected cases where it can aid in palliating symptoms.

Keywords: Chemotherapy; Endometrial cancer; Endometrial stromal sarcoma; Investigational therapies; Radiation; Uterine cancer; Uterine leiomyosarcoma; Uterine mesenchymal tumor; Uterine sarcoma.

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References

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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