State of the science: Uterine sarcomas: From pathology to practice

Shushkevich, Alexander; Thaker, Premal H.; Littell, Ramey D.; Shah, Naishadh A.; Chiang, Sarah; Thornton, Katherine A.; Hensley, Martee L.; Slomovitz, Brian M.; Holcomb, Kevin; Leitao, Mario M.; Toboni, Michael D.; Powell, Matthew A.; Levine, Douglas A.; Dowdy, Sean C.; Klopp, Ann H.; Brown, Jubilee

doi:10.1016/j.ygyno.2020.08.008

Cited by 9 publications

(11 citation statements)

References 53 publications

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“…The phase II OVARIO trial [ 22 ] evaluated the maintenance therapy of niraparib with bevacizumab in advanced ovarian cancer following first-line platinum-based CTx with bevacizumab. All patients (n=105) underwent tissue testing for homologous recombination deficiency (HRD).…”

Section: Ovarymentioning

confidence: 99%

Major clinical research advances in gynecologic cancer in 2020

et al. 2021

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In 2020 series, we summarized the major clinical research advances in gynecologic oncology with providing representative figures of the most influential study for 1 of each 3 gynecologic cancers: cervix, ovary, and uterine corpus. Review for cervical cancer covered targeted agents and immune checkpoint inhibitors, adjuvant radiation therapy or concurrent/sequential chemoradiation therapy after radical hysterectomy in early cervical cancer, radical surgery in early cervical cancer; and prevention and screening. Ovarian cancer research included studies of various combinations of poly (ADP-ribose) polymerase inhibitors with chemotherapy, immune checkpoint inhibitors, and/or vascular endothelial growth factor inhibitors according to the clinical setting. For uterine corpus cancer, molecular classification upon which the decision of adjuvant treatments might be based, World Health Organization recommendation of 2-tier grading system (low grade vs. high grade), sentinel lymph node assessment and ovarian preservation in clinically early-stage endometrial cancer were reviewed. Molecular targeted agents including immune checkpoint inhibitors which showed promising anti-tumor activities in advanced/recurrent endometrial cancer were also included in this review.

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Section: Ovarymentioning

confidence: 99%

Major clinical research advances in gynecologic cancer in 2020

et al. 2021

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“…Sarcomas of the uterine corpus are malignant neoplasms, which are further classified into mesenchymal tumors and mixed (epithelial plus mesenchymal) tumors [ 1 , 2 ]. The main issues concerning these neoplasms are the small number of clinical trials, insufficient data from evidence-based medicine, insignificant interest from the pharmaceutical industry, all of which close a vicious circle.…”

Section: Introductionmentioning

confidence: 99%

“…The low frequency of these malignancies implies insufficient experience in the diagnosis, hence incomplete surgical and complex treatment. Some uterine sarcomas (leiomyosarcoma, high-grade endometrial stromal sarcoma, undifferentiated sarcoma, adenosarcoma with sarcomatous overgrowth) have poor prognosis, whereas others (low-grade stromal sarcoma, adenosarcoma without sarcomatous overgrowth) are associated with good prognosis [ 2 ]. Surgical treatment is the first-line approach, as there are still insufficient data about neoadjuvant treatment [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…Some uterine sarcomas (leiomyosarcoma, high-grade endometrial stromal sarcoma, undifferentiated sarcoma, adenosarcoma with sarcomatous overgrowth) have poor prognosis, whereas others (low-grade stromal sarcoma, adenosarcoma without sarcomatous overgrowth) are associated with good prognosis [ 2 ]. Surgical treatment is the first-line approach, as there are still insufficient data about neoadjuvant treatment [ 1 , 2 ]. Moreover, the role of pelvic lymph node dissection, adjuvant chemoradiation, hormone and target therapies remain controversial [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…Surgical treatment is the first-line approach, as there are still insufficient data about neoadjuvant treatment [ 1 , 2 ]. Moreover, the role of pelvic lymph node dissection, adjuvant chemoradiation, hormone and target therapies remain controversial [ 1 , 2 ]. Pathologists’ experience is of paramount importance for an accurate diagnosis.…”

Section: Introductionmentioning

confidence: 99%

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New Aspects of Sarcomas of Uterine Corpus—A Brief Narrative Review

Kostov

Kornovski

Ivanova

et al. 2021

Clinics and Practice

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Sarcomas of the uterine corpus are rare malignant neoplasms, which are further classified into mesenchymal tumors, and mixed (epithelial plus mesenchymal) tumors. The main issues concerning these neoplasms are the small number of clinical trials, insufficient data from evidence-based medicine, insignificant interest from the pharmaceutical industry, all of which close a vicious circle. The low frequency of these malignancies implies insufficient experience in the diagnosis, hence incomplete surgical and complex treatment. Additionally, the rarity of these sarcomas makes it very difficult to develop clinical practice guidelines. Preoperative diagnosis, neoadjuvant and adjuvant chemoradiation, target and hormone therapies still raise many controversies. Disagreements about the role and type of surgical treatment are also often observed in medical literature. There are still insufficient data about the role of pelvic lymph node dissection and fertility-sparing surgery. Pathologists’ experience is of paramount importance for an accurate diagnosis. Additionally, genetics examinations become part of diagnosis in some sarcomas of the uterine corpus. Some gene mutations observed in uterine sarcomas are associated with different outcomes. Therefore, a development of molecular classification of uterine sarcomas should be considered in the future. In this review, we focus on the epidemiology, pathogenesis, pathology, diagnosis and treatment of the following sarcomas of the uterine corpus: leiomyosarcoma, low- and high-grade endometrial stromal sarcomas, undifferentiated sarcoma and adenosarcoma. Uterine carcinosarcomas are excluded as they represent an epithelial tumor rather than a true sarcoma.

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