Management of Uterine Sarcomas - Current Concepts and Controversies

Abstract

Uterine sarcomas are a group of relatively rare malignancies with heterologous clinical behavior. Because of its rarity, there is dearth of randomized trials and hence there are no standard recommendations as how to manage these cases. Carcinosarcomas are now a separate entity and is managed similar to high grade endometrial carcinoma, since the sarcomatous element is proven to be of endometrial origin. Now, the major variants are leomyosarcoma (LMS), endometrial stromalsarcoma (ESS) and high grade undifferentiated uterine sarcoma (HGUS). Recently, immunohistochemistry markers are introduced for proper typing of these tumors. Pre- operative diagnosis is seldom possible and surgery remains the cornerstone of its management. Local radiation is found to be beneficial in adjuvant setting with improved locoregional failure free survival (LRFFS) without a proven benefit in overall survival. Adjuvant chemotherapy also is yet to demonstrate overall survival benefit. Multi-institutional studies through international rare cancer initiative may generate ample evidence for standard treatment guidelines in these rare tumors and hence participation in clinical trials is highly recommended.

Keywords: Uterine sarcomas, ESS, LMS, HGUS, adjuvant, radiation, chemotherapy

Cite this Article

Beena K, Anand RK. Management of Uterine Sarcomas-Current Concepts and Controversies. Research and Reviews: Journal of Oncology and Hematology. 2015; 4(3): 19–26p