Management of sarcomas of the uterus

Novetsky, Akiva P.; Powell, Matthew A.

doi:10.1097/cco.0b013e328363e0ef

Cited by 20 publications

(19 citation statements)

References 68 publications

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“…Approximately 30–50% of patients with ESS show atypical symptom of abnormal uterine bleeding . Positive lymph nodes are usually associated with extrauterine metastasis, deep myometrial invasion and lymphvascular space invasion, which also could enlarge nodes . Therefore, the benefits of systematic LND remain controversial.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, the primary treatment for early stage is a total hysterectomy (TH) plus a bilateral salpingo‐oophorectomy (BSO) . Whether it is necessary for LGESS patients to undergo lymph node dissection (LND) accompanied with TH and BSO is still controversial since lymph node metastasis (LNM) are usually associated with an advanced grade as well as extra uterine disease, deep myometrial invasion and lymph‐vascular invasion …”

Section: Introductionmentioning

confidence: 99%

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Long‐term impact of lymphadenectomies in patients with low‐grade, early‐stage uterine endometrial stroma sarcoma

Zhang

Wang

et al. 2020

J of Obstet and Gynaecol

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Aim The aim of our study was to investigate the lymph node metastasis (LNM) rate and effect of lymph node dissection (LND) in patients with stage I, low‐grade endometrial stromal sarcoma (LGESS). Methods Patients with stage I LGESS (n = 119) that underwent surgery from July 1969 to July 2017, following up over 48 years at the China National Cancer Center were retrospectively analyzed in this study. Results Surgical records and consulting data for patients with LGESS were analyzed to find that 47 patients received systematic pelvic LND. The number of patients with menopause in the LND(+) group were significantly lower than those in LND(−) group (2.1% vs 22.2%, P = 0.005), meanwhile, patients received bilateral salpingo‐oophorectomy procedure in LND(+) group were significantly higher than LND(−) (97.9% vs 58.3%, P < 0.001). Neither progression‐free survival nor overall survival was significantly improved in the LND(+) group even after propensity score matching although the progression‐free survival has a stronger trend in LND(+) population. Conclusion A systematic LND was not significantly associated with prognosis for patients with early‐stage LGESS. There is no sufficient indication for a systematic LND for patients with early‐stage LGESS. A systematic LND might be necessary if enlarged lymph nodes were detected by image graphology or observation during surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long‐term impact of lymphadenectomies in patients with low‐grade, early‐stage uterine endometrial stroma sarcoma

Zhang

Wang

et al. 2020

J of Obstet and Gynaecol

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“…Gynaecological leiomyosarcomas (gLMS) represent a heterogeneous group of soft tissue sarcoma [1][2][3] of mesenchymal origin [1], that although have a rare incidence, present high aggressiveness, and propensity to infiltrate secondary organs [4][5][6][7][8][9][10], poor prognosis and lethality because of the lack of effective treatments [11,12].…”

Section: Introductionmentioning

confidence: 99%

MMPs and angiogenesis affect the metastatic potential of a human vulvar leiomyosarcoma cell line

Alias

Rocchi

Ribatti

et al. 2015

J Cellular Molecular Medi

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Gynaecological leiomyosarcoma (gLMS) represent a heterogeneous group of soft tissue sarcoma, characterized by rare incidence, high aggressiveness and propensity to infiltrate secondary organs, poor prognosis and lethality, because of the lack of biological mechanisms that underlying their progression and effective pharmaceutical treatments. This study was focused on some of the aspects of progression and dissemination of a subtype of gLMS namely vulvar LMS (vLMS). We therefore used a vulvar LMS-derived cell line namely SK-LMS-1, coupled with in vitro and in vivo assays. We observed that SK-LMS-1 cells have a strong invasive capacity in vitro, through the activity of matrix metalloproteinases 2 and 9, while in vivo these cells induce a strong angiogenic response and disseminate to the chick embryo liver. Therefore, we postulate that metalloproteinases are involved in the spreading behaviour of SK-LMS-1. Further investigations are necessary to better understand the molecular and cellular machinery involved in the progression of this malignancy.

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“…This entity, previously known as malignant mixed Müllerian tumours, is considered to be a type of high-grade endometrial carcinoma ("metaplastic carcinoma") according to the 2009 International Federation of Gynecology and Obstetrics classification, 25 in line with the classification that is applied to other organs.…”

Section: Carcinosarcomamentioning

confidence: 99%

“…26 Nevertheless, the five-year, diseasefree survival of carcinosarcoma, stage by stage, was found to be worse than that for serous carcinoma, clear cell carcinoma and grade 3 endometrioid adenocarcinoma (53.4% vs. 59%, 68.8% and 76.2%, respectively). 25 Although typically, both components are high grade, rarely one or the other may be low grade, widening the differential diagnoses to include MASO. Frank malignant features are absent from the epithelial component in the latter.…”

Section: Carcinosarcomamentioning

confidence: 99%

Small biopsy pathology of mass lesions of the endometrial cavity: differential diagnostic considerations

Liptak

Barnetson

2014

Southern African Journal of Gynaecological Oncology

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Sampling for histological examination is usually part of the work-up for further planning with regard to the management of patients presenting with uterine bleeding. This review, utilising the classification of the World Health Organization, aims to discuss some commonly recurring differential diagnostic problems on small biopsy specimens. Diagnostic difficulties generally relate to representativeness of the sample, determining the site of the lesion, and fragmentation and trauma artefact. Reference is made to clinical relevance, and attention drawn to some lesser known diagnostic entities. Morphological features and immunohistochemical markers that are useful in certain differential diagnostic scenarios are highlighted. The level of diagnostic certainty should be indicated in the report, and when the limitations do not permit a definite diagnosis in a small sample, the pathologist should provide the clinician with a differential diagnosis on which further management decisions can be based. P Peer reviewed.

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Management of sarcomas of the uterus

Cited by 20 publications

References 68 publications

Long‐term impact of lymphadenectomies in patients with low‐grade, early‐stage uterine endometrial stroma sarcoma

Long‐term impact of lymphadenectomies in patients with low‐grade, early‐stage uterine endometrial stroma sarcoma

MMPs and angiogenesis affect the metastatic potential of a human vulvar leiomyosarcoma cell line

Small biopsy pathology of mass lesions of the endometrial cavity: differential diagnostic considerations

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