Management of uterine sarcomas and prognostic indicators: real world data from a single-institution

Kyriazoglou, Anastasios; Liontos, Michalis; Ziogas, Dimitrios C.; Zagouri, Flora; Koutsoukos, K.; Tsironis, Georgios; Tsiara, Anna; Kaparelou, Maria; Zakopoulou, Roubini; Thomakos, Nikolaos; Haidopoulos, Dimitrios; Papaspyrou, Irene; Rodolakis, Alexandros; Bamias, Aristotelis; Dimopoulos, Meletios A.

doi:10.1186/s12885-018-5156-1

Cited by 32 publications

(37 citation statements)

References 35 publications

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“…In their study group, increased mitotic index was the only recognized independent significant prognostic factor in the multivariate analysis. Their study group was heterogeneous and no significant impact of adjuvant therapy could be drawn as a result, which is in line with other studies (20) . Further insights are needed for the adjuvant treatment of uterine sarcomas.…”

Section: Tab 4 the Treatment Modality And Recurrence Pattern Of Patsupporting

confidence: 86%

Uterine sarcomas: 7-year experience from a tertiary center

Yetimalar¹,

Kılıç²,

Yiğit³

2020

Curr Gynecol Oncol

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Uterine sarcomas are rare and aggressive gynecologic malignancies. Due to their rarity, histopathologic heterogeneity and molecular diversity, the optimal approach is still a matter of debate. Debulking surgery is still the mainstay of the treatment. But adjuvant treatment strategies remain controversial. In this study, we aimed to examine the clinical characteristics, histopathological features, tumoral behavior and recurrence patterns of patients diagnosed with uterine sarcoma at a tertiary referring center over a 7-year period. A total of 427 patients who were treated for uterine cancer between 2007 and 2014 were analyzed retrospectively. There were in total 20 patients diagnosed with uterine sarcoma. Median age of all patients diagnosed as uterine sarcomas was 50.5 years [interquartile range 11.5 (43.5-55)]. The median tumor size in these patients was 5.75 cm [interquartile range 4.38 (4.12-8.50)]. There were 5 patients with leiomyosarcomas, 10 patients with endometrial stromal sarcomas, 4 patients with undifferentiated uterine sarcomas and 1 patient with adenosarcoma. Despite our limited data, we presented our retrospective series over a period of 7 years. Prospective data and further insights are needed to better understand the tumor biology and improve treatment modalities.

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Section: Tab 4 the Treatment Modality And Recurrence Pattern Of Patsupporting

confidence: 86%

Uterine sarcomas: 7-year experience from a tertiary center

Yetimalar¹,

Kılıç²,

Yiğit³

2020

Curr Gynecol Oncol

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“…Moreover, the ultrasonographic differential diagnosis between fibroids and uterine sarcomas remains a challenge, and there is no clear consensus on the ultrasound features of uterine sarcoma. Recent evidence reports that in case of solid uterine masses with inhomogeneous echogenicity, irregular cystic areas, absence of fan-shaped shadowing, and moderately to very well vascularization 40 , further evaluation and appropriate management are needed 41 , considering the poor prognosis and the therapeutic possibilities 42 .…”

Section: Discussionmentioning

confidence: 99%

The association between childbirth, breastfeeding, and uterine fibroids: an observational study

Carpini

Morini

Papiccio

et al. 2019

Sci Rep

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The aim of this study was to investigate the effect of childbirth and breastfeeding on uterine fibroids and to identify the factors associated with size variations. This was a monocenter observational study carried on women with a sonographic diagnosis of uterine fibroids from January 2007 to December 2016, with no indication for immediate treatment, and who became pregnant within one year from diagnosis. All patients were re-evaluated six months after delivery. Fibroid diameters were compared between pre-pregnancy period, first, second, third trimester and post-delivery. The rate of “regressed” (growth of diameter <−40%), “unchanged” (growth of diameter between −40% and +40%) or “increased” (growth of diameter >+40%) fibroids at the post-delivery evaluation with respect to the pre-pregnancy state was calculated. One-hundred fifty-seven women were included in the final analysis. At the post-delivery ultrasound, a significant reduction of the fibroid diameter with respect to all previous examinations was observed, and there was no evidence of 67 (37.2%) fibroids. Ongoing breastfeeding was positively associated with an “unchanged” or “regressed” fibroid diameter (adOR 3.23, 95%CI: 1.35–7.70, p < 0.01). Smaller pre-gravidic fibroids were more likely to return to pre-pregnancy dimensions or to regress, with a cut-off of 32 mm for lactating women and of 26 mm for non-lactating women. In conclusion, fibroids seem to return to pre-pregnancy dimensions or to regress in the post-partum period. This process may be sustained by uterine involution and hormonal variations, with an additional role of breastfeeding.

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“…UUS is a rare uterine sarcoma [ 115 , 116 , 117 ] that includes a variegated group of neoplasms with no specific line of differentiation and, by definition, is a diagnosis of exclusion. The patients with UUS are postmenopausal and present with uterine bleeding and pelvic pain.…”

Section: Undifferentiated Uterine Sarcomas (Uus)mentioning

confidence: 99%

Update on Endometrial Stromal Tumours of the Uterus

2021

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Endometrial stromal tumours (ESTs) are rare, intriguing uterine mesenchymal neoplasms with variegated histopathological, immunohistochemical and molecular characteristics. Morphologically, ESTs resemble endometrial stromal cells in the proliferative phase of the menstrual cycle. In 1966 Norris and Taylor classified ESTs into benign and malignant categories according to the mitotic count. In the most recent classification by the WHO (2020), ESTs have been divided into four categories: Endometrial Stromal Nodules (ESNs), Low-Grade Endometrial Stromal Sarcomas (LG-ESSs), High-Grade Endometrial Stromal Sarcomas (HG-ESSs) and Undifferentiated Uterine Sarcomas (UUSs). ESNs are clinically benign. LG-ESSs are tumours of low malignant potential, often with indolent clinical behaviour, with some cases presented with a late recurrence after hysterectomy. HG-ESSs are tumours of high malignant potential with more aggressive clinical outcome. UUSs show high-grade morphological features with very aggressive clinical behavior. With the advent of molecular techniques, the morphological classification of ESTs can be integrated with molecular findings in enhanced classification of these tumours. In the future, the morphological and immunohistochemical features correlated with molecular categorisation of ESTs, will become a robust means to plan therapeutic decisions, especially in recurrences and metastatic disease. In this review, we summarise the morphological, immunohistochemical and molecular features of ESTs with particular reference to the most recent molecular findings.

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Management of uterine sarcomas and prognostic indicators: real world data from a single-institution

Cited by 32 publications

References 35 publications

Uterine sarcomas: 7-year experience from a tertiary center

Uterine sarcomas: 7-year experience from a tertiary center

The association between childbirth, breastfeeding, and uterine fibroids: an observational study

Update on Endometrial Stromal Tumours of the Uterus

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