Uterine sarcomas.Analysis of failures with special emphasis on the use of adjuvant radiation therapy

Salazar, Omar M.; Bonfiglio, Thomas A.; Patten, Stanley F.; Keller, Bowen E.; Feldstein, Michael; Dunne, Margaret E.; Rudolph, Jerome H.

doi:10.1002/1097-0142(197809)42:3<1161::aid-cncr2820420320>3.0.co;2-c

Cited by 100 publications

(22 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It is beyond the scope of this paper to entertain a detailed dissertation on failure pathways of uterine sarcoma; they will be the subject of a separate report. 26 Nevertheless it is only after analyzing the spread patterns of these tumors that one can realize that the actual benefit of adjuvant radiation therapy is to increase the chances of tumor control in the pelvis. Furthermore, only after spread patterns are understood can one arrive at a realistic therapeutic approach for these tumors.…”

Section: Therapeutic Considerationsmentioning

confidence: 99%

Uterine sarcomas.Natural history, treatment and prognosis

Salazar

Bonfiglio

Patten

et al. 1978

Cancer

Self Cite

192

View full text Add to dashboard Cite

Seventy-three documented cases of uterine sarcoma were treated at the University of Rochester Strong Memorial Hospital from 1955 to 1975. Thirtythree patients (45%) were treated with surgery only [S], 31 (43%) with surgery and radiation [S + R], and 9 (12%) with radiation alone [R]. A review of the literature with over 900 cases was also performed. Several important issues regarding these rare tumors are addressed, such as the prognosis of the several histologic variants, the role of radiation therapy in their management and what perhaps may constitute a comprehensive therapeutic approach. These tumors are characterized by local aggressiveness and early widespread dissemination. There are three main histologic varieties: mixed mesodermal sarcoma (MMS), leiomyosarcoma (LMS) and endometrial stromal sarcoma (ESS).Of the three, MMS was the most common, seen in 60% of the cases; LMS occurred in younger patients and tended to be localized to the uterine corpus (Stage I) in 80% of the instances. Tumor extent at diagnosis was the main prognosticator for survival in uterine sarcomas; patients with Stage I tumors had a significantly lower incidence of recurrences, as well as a better survival than patients with more advanced tumors. Stage-by-stage, there were no significant differences in survival among the pathologic variants. To ensure adequate staging, a surgical procedure is recommended first whenever possible. Adjuvant radiation therapy significantly improved disease controlability in the pelvis, although it may not have dramatically affected the final outcome. In addition to pelvic irradiation, some form of systemic therapy should be administered to decrease distant metastases.

show abstract

Section: Therapeutic Considerationsmentioning

confidence: 99%

Uterine sarcomas.Natural history, treatment and prognosis

Salazar

Bonfiglio

Patten

et al. 1978

Cancer

Self Cite

192

View full text Add to dashboard Cite

show abstract

“…Salazar y cols (7,8) analizaron 73 pacientes con sarcoma uterino, de los cuales un 60% fueron tumores mesodérmicos mixtos. La cirugía más común fue histerectomía total y salpingo-ooforectomía.…”

Section: Tumores Mesodermicos Mixtos O Carcinosarcomas (Tabla Ii)unclassified

“…Salazar y cols (7,8) observaron 20 leiomiosarcomas de los cuales un 90% recibió cirugía exclusiva y un 10% cirugía asociada a radioterapia. La sobrevida global a 5 años fue de 63%.…”

Section: Leiomiosarcomas Uterinos (Tabla Iii)unclassified

“…En pacientes con etapa I y II tratados con radioterapia adyuvante se ha observado mejor control local (7,8,9,11,12,13,17) y sobrevida causa específica (18), siendo su rol en sobrevida global controversial.…”

Section: Discusión Y Conclusionesunclassified

“…En el caso de pacientes médicamente inoperables, con enfermedad avanzada o recurrente las alternativas terapéuticas consisten en radioterapia paliativa exclusiva (7,8) o quimioterapia paliativa (19).…”

Section: Discusión Y Conclusionesunclassified

See 2 more Smart Citations

Sarcomas Uterinos: Manejo Actual

2005

Rev. chil. obstet. ginecol.

View full text Add to dashboard Cite

RESUMENSarcomas uterinos son un grupo raro, heterogéneo y agresivo de neoplasias que conduce frecuentemente a una diseminación y muerte temprana. En ausencia de trabajos prospectivos randomizados fase III las recomendaciones de tratamiento para pacientes con sarcoma uterino son basadas en resultados de estudios retrospectivos lo que dificulta su manejo clínico. El tratamiento principal es la cirugía, teniendo los tratamientos adyuvantes un rol controversial. La presente revisión analiza estudios clínico-patológicos, factores pronósticos y el manejo actual de sarcomas uterinos.PALABRAS CLAVES: Sarcoma uterino, tumores mesodérmicos mixtos, leiomiosarcoma, sarcoma estroma endometrial, manejo SUMMARYUterine sarcomas are a rare and heterogeneous group of neoplasm, with an aggressive behavior leading to an early dissemination and death. In the absence of phase III, prospective randomized studies, treatment recommendations for patients with uterine sarcoma must be based on the results of retrospective studies making their management difficult. The principal treatment is surgery with a controversial role of the adjuvant therapy. The present review analyzes clinic-pathologic studies, prognostic factors and current management of uterine sarcomas.KEY WORDS: Uterine sarcomas, leiomyosarcomas, endometrial stromal sarcomas, mixed mesodermal tumors, management Documentos INTRODUCCIÓNSarcomas uterinos son tumores poco frecuentes que representan menos del 3% de todos los cánceres del tracto genital femenino y entre 3-7% de todos los cánceres del cuerpo uterino (Tabla I) (1). Representan un grupo heterogéneo de neoplasias que se desarrollan del miometrio (leiomiosarcomas) y desde la mucosa uterina (sarcomas del estroma endometrial y sarcomas mesodér-micos mixtos) (2). Tienen un pronóstico pobre con una sobrevida global en general menor del 50% a 2 años, incluso en etapas tempranas de la enfermedad (3,4,5). Debido a la rareza de este tumor, así como también a su diversidad patológi-ca no existen estudios prospectivos randomizados fase III, por lo que las recomendaciones de tratamiento deben ser basadas en revisiones retrospectivas de pequeñas series, lo que asociado a su mal pronóstico hacen difícil su manejo clínico.El propósito de este documento es revisar características clínico patológicas, factores pronósticos y tratamiento de los principales subtipos de sarcoma uterino.

show abstract