Current status of the adjuvant therapy in uterine sarcoma: A literature review

Abstract

Uterine sarcomas (US) are rare mesenchymal tumours accounting approximately for 3%–7% of all uterine cancers. Histologically, US are classified into mesenchymal tumours or mixed epithelial and mesenchymal tumours. The group of mesenchymal tumours includes uterine leiomyosarcoma (uLMS, 65% of cases), endometrial stromal sarcoma (ESS, 21%) – traditionally divided into low grade (LG-ESS) and high grade–undifferentiated uterine sarcoma (5%) and other rare subtypes such as alveolar or embryonal rhabdomyosarcoma. Despite the fact that several drugs demonstrated clinical activity in advanced or metastatic settings, the role of postoperative therapy in US remains controversial. In this review, we have summarised the current state of the art, including the chief trials on adjuvant treatment modalities in US, especially focusing on uLMS, LG-ESS and other rare histotypes.

Circulating Tumor DNA in Biliary Tract Cancer: Current Evidence and Future Perspectives

“…More specifically, the majority of cfDNA comes from normal cells; conversely, a small part of cfDNA directly comes from primary tumors, metastatic sites or CTCs, and it is called ctDNA (38)(39)(40). The possibility to detect biological, tumor-derived material circulating in body fluids may have remarkable applications in any phase of cancer management in terms of earlier diagnosis, detection of relapse, identification of therapeutic targets, monitoring of treatment response and tracking emergence of resistance (41)(42)(43)(44).…”

Recurrent Uterine Smooth-Muscle Tumors of Uncertain Malignant Potential (STUMP): State of The Art

“…The prognostic impact of additional treatment is currently not defined, and no recommendable strategies are available. No satisfying data about adjuvant treatment exist, be it radiotherapy, chemotherapy or endocrine therapy, and authors agree on recommending treatment on an individual basis (5,20,36,50).…”

Genomic Database Analysis of Uterine Leiomyosarcoma Mutational Profile

“…Surgery remains the gold standard treatment for early stage uLMS, but the risk of recurrence is estimated around 50 to 70% [ 3 , 5 , 6 ]. Even though several drugs demonstrated clinical activity in advanced or metastatic setting, the role of postoperative adjuvant therapy in uLMS in order to reduce the risk of recurrence remains controversial [ 7 , 8 ]. In the advanced or metastatic uLMS, chemotherapy is considered the standard approach [ 9 , 10 , 11 ].…”