Uterine Sarcoma: Analysis of 13,089 Cases Based on Surveillance, Epidemiology, and End Results Database

Hosh, Mona; Antar, Sarah; Nazzal, Ahmed; Warda, Mahmoud; Gibreel, Ahmed; Refky, Basel

doi:10.1097/igc.0000000000000720

Cited by 164 publications

(152 citation statements)

References 14 publications

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“…The mainstay treatment for ESS consists of total hysterectomy and bilateral salpingo‐oophorectomy, while lymphadenectomy remains controversial in stage I–II of the disease. Adjuvant treatments, including chemotherapy, radiation and endocrine therapy, may have a role in advanced and recurrent disease . The 5‐year overall survival in stage I low‐grade ESS is excellent (IA 100%, IB 93.5%) .…”

Section: Introductionmentioning

confidence: 99%

Recurrence after fertility‐preserving surgery for low‐grade endometrial stromal sarcoma

Chin

Lin

et al. 2018

J of Obstet and Gynaecol

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Considering the characteristics of low-grade endometrial stromal sarcoma (ESS), such as relative indolent course, younger age at diagnosis and favorable prognosis, the fertility-preserving management of low-grade ESS has been described by several authors. We report a 34-year-old female with stage IB low-grade ESS who developed recurrence 7 years after neoadjuvant high-dose progestin therapy followed by fertility-preserving surgery and postoperative progestin therapy. The patient stopped progestin therapy and was disease free for 4 years after diagnosis but experienced recurrence with peritoneal dissemination at 7 years. Considering the tendency of late recurrence, long-term surveillance is necessary to ensure timely action. Long-term progestin treatment might be considered after complete remission even beyond 5 years. We performed a literature review and found that many of the cases did not meet solid pathological criteria of low-grade ESS. The diagnostic criteria of low-grade ESS (vs endometrial stromal nodule) should be deliberately documented for future studies of this rare disease.

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Section: Introductionmentioning

confidence: 99%

Recurrence after fertility‐preserving surgery for low‐grade endometrial stromal sarcoma

Chin

Lin

et al. 2018

J of Obstet and Gynaecol

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“…However, due to the aggressive nature of carcinosarcomas, over 10% of patients will present with metastatic disease at the initial diagnosis, and up to 60% will have extrauterine disease according to imaging [5]. …”

Section: Diagnosismentioning

confidence: 99%

Uterine Carcinosarcomas - Diagnosis and Management

Denschlag

Ulrich

2018

Oncol Res Treat

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Uterine carcinosarcomas are rare tumors that account for less than 5% of all uterine malignancies. These tumors (previously called malignant mixed Müllerian tumors) are dedifferentiated carcinomas that comprise carcinomatous and sarcomatous elements and arise from a single malignant clone. They are considered a high-risk variant of endometrial adenocarcinoma because carcinosarcomas share more similarities in epidemiology, risk factors, and clinical behavior with endometrial carcinoma than with uterine sarcomas. The clinical features, diagnosis, staging, and treatment of uterine carcinosarcoma will be discussed in this review.

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“…Although uterine leiomyosarcomas (uLMS) account for fewer than 5% of all uterine malignancies, they represent approximately half of all uterine sarcomas. [1–3] The treatment of metastatic uLMS remains a considerable challenge. First- and second-line chemotherapy options include fixed dose rate gemcitabine plus docetaxel, which achieves an objective response in approximately 30% of patients [4, 5], single-agent gemcitabine, which achieves an objective response in approximately 20% of patients, and doxorubicin-based treatment, with similar objective responses [6].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of trabectedin or dacarbazine in patients with advanced uterine leiomyosarcoma after failure of anthracycline-based chemotherapy: Subgroup analysis of a phase 3, randomized clinical trial

Hensley

Patel

Mehren

et al. 2017

Gynecologic Oncology

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Objective Trabectedin demonstrated significantly improved disease control in leiomyosarcoma and liposarcoma patients in a global phase 3 trial (NCT01343277). A post hoc analysis was conducted to assess the efficacy and safety of trabectedin or dacarbazine in women with uterine leiomyosarcoma (uLMS), the largest subgroup of enrolled patients (40%). Methods Of 577 patients randomized 2:1 to receive trabectedin 1.5 mg/m2 by 24-hour IV infusion or dacarbazine 1 g/m2 by 20–120-minute IV infusion once every three weeks, 232 had uLMS (trabectedin: 144; dacarbazine: 88). The primary endpoint was overall survival (OS); secondary endpoints were progression-free survival (PFS), objective response rate (ORR), clinical benefit rate (CBR: complete responses + partial responses + stable disease [SD] for at least 18 weeks), duration of response (DOR), and safety. Results PFS for trabectedin was 4.0 months compared with 1.5 months for dacarbazine (hazard ratio [HR]=0.57; 95% CI 0.41–0.81; P=.0012). OS was similar (trabectedin 13.4 months vs. dacarbazine 12.9 months, HR=0.89; 95% CI 0.65–1.24; P=.51) between groups. ORR was 11% with trabectedin vs. 9% with dacarbazine (P=.82). CBR for trabectedin was 31% vs. 18% with dacarbazine (P=.05); median DOR was 6.5 months for trabectedin vs. 4.1 months for dacarbazine (P=.32). Grade 3/4 treatment-emergent adverse events observed in ≥10% of patients in the trabectedin group included transient aminotransferase (aspartate/alanine) elevations, anemia, leukopenia, and thrombocytopenia. Conclusions In this post hoc subset analysis of patients with uLMS who had received prior anthracycline therapy, trabectedin treatment resulted in significantly longer PFS versus dacarbazine, with an acceptable safety profile. There was no difference in OS.

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Uterine Sarcoma: Analysis of 13,089 Cases Based on Surveillance, Epidemiology, and End Results Database

Abstract: Uterine sarcoma is an aggressive tumor that occurs more in old age and among women of black race. Poor survival was associated with old age, black race, and advanced disease stage. Radiotherapy in patients with localized stage does not improve the survival.

Cited by 164 publications

References 14 publications

Recurrence after fertility‐preserving surgery for low‐grade endometrial stromal sarcoma

Recurrence after fertility‐preserving surgery for low‐grade endometrial stromal sarcoma

Uterine Carcinosarcomas - Diagnosis and Management

Efficacy and safety of trabectedin or dacarbazine in patients with advanced uterine leiomyosarcoma after failure of anthracycline-based chemotherapy: Subgroup analysis of a phase 3, randomized clinical trial

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