Uterine leiomyosarcoma: Epidemiology, contemporary treatment strategies and the impact of uterine morcellation

Ricci, Stephanie; Stone, Rebecca L.; Fader, Amanda N.

doi:10.1016/j.ygyno.2017.02.019

Cited by 168 publications

(169 citation statements)

References 67 publications

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“…In the USA this led to a considerable reduction of endoscopic surgery for uterine fibroids during the following years. As the incidence of uLMS is low and many women have profited from endoscopic surgery for myomectomy or hysterectomy, this fall-back to higher rates of open abdominal surgery has been regretted among endoscopic surgeons, and has caused a controversial debate concerning the FDA warning [3]. There is no doubt that risk groups have to be defined more precisely and that there is urgent need for a well evaluated risk score.…”

Section: Analysis Of Case Report and Discussionmentioning

confidence: 99%

“…Whereas remission rates have been modest, a no-change situation could be reached for more than 10 cycles in 50% of patients [42]. Promising results from a French Sarcoma Group trial combining trabectedin with doxorubicin and a randomized trial comparing trabectedin to dacarbazine in soft tissue sarcoma led to FDA approval of trabectedin [3] in advanced and recurrent uLMS.…”

Section: Therapy Of Relapse And/or Metastasismentioning

confidence: 99%

“…A double-blind, placebo-controlled phase III study (PALETTE) included different uterine sarcomas, including 50% uLMS, and pazopanib significantly prolonged PFS in all patients as well as in the uLMS subgroup [43]. This study led to the FDA approval of pazopanib for uLMS [3]. …”

Section: Therapy Of Relapse And/or Metastasismentioning

confidence: 99%

“…uLMS is rarely suspected before operation and more often detected accidentally after removing the uterus or single uLM with or without morcellation. Although absolute numbers of uLMS detected post-surgically are small - numbers in the literature range from 1:498 [3] to 1:1,851 [4] out of all uterine myoma interventions - inadequate operation is considered detrimental for the individual patient and should be prevented.…”

Section: Introductionmentioning

confidence: 99%

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Uterine Leiomyosarcoma

et al. 2018

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Uterine leiomyosarcoma (uLMS) is a rare entity among malignant gynecologic tumors with a very unfavorable prognosis and the highest prevalence in the pre- and peri-menopause. Only early-stage tumors have an acceptable prognosis, provided the patient has been treated without injuring the uterus. uLMS is often diagnosed accidentally and the correct diagnosis ishampered by equivocal features similar to the far more frequent benign uterine fibroids. Surgery is the basis of therapy, and it should be done in order to remove the uterus intact. As vaginal, abdominal, and endoscopic surgery - possibly including morcellation - are the methods of choice for the treatment of uterine fibroids, pre-operatively undiagnosed leiomyosarcoma detected by pathologic examination will have a worsened prognosis. Systemic treatment and radiotherapy are of no proven value in the adjuvant setting. Thus, there is strong need for a reliable pre-operative risk score for leiomyosarcoma in order to justify diagnostic means beyond clinical routine and to choose the correct surgical pathway. The clinical problems in the diagnosis of leiomyosarcoma and treatment are exemplified by a case report of a 30-year-old childless patient. Diagnostic tools as well as treatment options in adjuvant and palliative situations are reviewed.

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Section: Analysis Of Case Report and Discussionmentioning

confidence: 99%

Section: Therapy Of Relapse And/or Metastasismentioning

confidence: 99%

Section: Therapy Of Relapse And/or Metastasismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Uterine Leiomyosarcoma

et al. 2018

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“…Leiomyosarcomas (LMS) of the pelvis are typically either derived from vascular structures, such as the iliac vein (or less commonly the iliac artery), or the uterus . Rarely, LMS may originate from the ureter or the prostate .…”

Section: Introductionmentioning

confidence: 99%

Soft tissue tumors of the pelvis: Technical and histological considerations

Mullen

Houdt

2017

Journal of Surgical Oncology

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In this review, we first address the anatomic and technical considerations in the resection of pelvic soft tissue tumors, including the challenges unique to these tumors, such as the narrow anatomic confines of the bony pelvis, the often locally aggressive nature of these tumors, as well as the major functional deficits that may result from their resection. We then review the optimal, multidisciplinary, histology-driven treatment approach to pelvic tumors.

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Mesenchymal and Non‐Epithelial Tumors of the Pelvis

Schwarzkopf¹,

Boland²

2021

Surgical Management of Advanced Pelvic Cancer

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Uterine leiomyosarcoma: Epidemiology, contemporary treatment strategies and the impact of uterine morcellation

Cited by 168 publications

References 67 publications

Uterine Leiomyosarcoma

Uterine Leiomyosarcoma

Soft tissue tumors of the pelvis: Technical and histological considerations

Mesenchymal and Non‐Epithelial Tumors of the Pelvis

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