Uterine sarcoma part III—Targeted therapy: The Taiwan Association of Gynecology (TAG) systematic review

Yen, Ming‐Shyen; Chen, Jen‐Ruei; Wang, Peng-Hui; Wen, Kuo-Chang; Chen, Yi Jen; Ng, Heung‐Tat; Chang, Yen-Hou; Chang, Yi Wen; Chao, Hsiang‐Tai; Chao, Kuan-Chong; Chuang, Chi-Mu; Ho, Chi-Hong; Horng, Huann-Cheng; Huang, Chen‐Yu; Jiang, Ling-Yu; Liu, Chia-Hao; Li, Hsin-Yang; Sun, Pi-Lin; Wu, Hsiang Ling; Ju, Fong-Yuan; Tsai, Chih-Ping; Chang, Wen-Hsun; Hsu, Yen-Mei; Huang, Shu-Yun; Lee, Na-Rong; Chen, Chih-Yao; Chang, Wen‐Chun; Chen, Chii-Hou; Chen, Ruey-Jian; Chow, Song‐Nan; Lien, Yih-Ron; Sheu, Bor‐Ching; Torng, Pao-Ling; Wei, Lin-Hung; Yen, Men‐Luh; Lee, Wen-Ling; Wang, Kuan-Chin; Chang, Chih‐Long; Chen, Chih‐Ping; Chen, Tze-Chien; Huang, Jian‐Pei; Huang, Ming-Chao; Wang, Yeou-Lih; Chang, Cheng‐Chang; Liu, Jah‐Yao; Su, Her-Young; Wang, Yu-Chi; Yu, Mu-Hsien; Chu, Ching-Chuang; Huang, Lee-Wen; Seow, Kok-Min; Lai, Tsung‐Ching; Lee, Fa‐Kung; Chen, Ching‐Hui; Liu, Weimin; Chiou, Jyh-Shin; Huang, Ben-Shian; Lu, Yen-Feng; Hsiao, Sheng-Mou; Sun, Hsu-Dong; Wu, Wen-Yih; Teng, Shiyong; Chen, Kuo-Hu; Hung, Jeng-Hsiu; Lai, Hung-Cheng; Yuan, Chiou‐Chung; Hsieh, Ching-Hung; Wang, Chin‐Jung; Chan, Che-Kai; Chang, Shing‐Jyh; Shih, Cheng‐Ping; Hung, Man‐Jung; Hsu, Shih-Tien; Ke, Yu-Min; Lu, Chien-Hsing; Sun, Lou; Chang, Wei-Chun; Hung, Yao-Ching; Lin, Wu-Chou; Wang, Po-Hui; Chen, Tze-Ho; Wu, Meng-Hsiu; Li, Yiu‐Tai; Huang, Kuo-Feng; Chuang, Fei‐Chi; Fu, Hai-Xia; Kung, Fu‐Tsai; Huang, Kuo‐Tung; Chen, San-Nung; Chiang, An‐Jen; Li, Ju-Yueh; Liou, William W.; Lin, Lie Chwen; Tsai, Hsiao Wen; Tsui, Kuan‐Hao

doi:10.1016/j.tjog.2016.07.001

Cited by 15 publications

(10 citation statements)

References 76 publications

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“…LG-ESS is an indolent tumor with favorable prognosis, which is often sensitive to hormone therapy. The 5-year overall survival (OS) rate for stage I patients is >90%, while that of patients in stages III and IV is 50% 4,7–9. However, patients with HG-ESS experience earlier and more frequent recurrences (often <1 year) and are at a higher risk of death due to the disease.…”

Section: Introductionmentioning

confidence: 99%

<p>High-grade endometrial stromal sarcoma: a retrospective study of factors influencing prognosis</p>

Zhang¹,

Li²,

Qin³

et al. 2019

CMAR

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ObjectivesThe aim of this study was to evaluate the factors associated with progress-free survival (PFS) and overall survival (OS) in patients with high-grade endometrial stromal sarcoma (HG-ESS).Patients and methodsA total of 40 patients were enrolled in this study at the Peking Union Medical College Hospital, Beijing, China, from 2006 to 2016. The study retrospectively analyzed clinical and pathological data, and associations of these variables with PFS and OS were evaluated.ResultsThe age of the patients at the time of diagnosis ranged from 16 to 73 years. Abnormal vaginal bleeding was the most commonly observed symptom. The tumor size ranged from 2 to 19 cm. The tumor locations were as follows: vulva (1 case), ovary (2 cases), broad ligament (2 cases), cervix (7 cases), and uterus (28 cases). A total of 34 (85%) and 6 (15%) patients underwent complete and ovarian preservation surgery, respectively. Notably, 33 (82.5%), 13 (32.5%), and 5 (12.5%) patients received adjuvant chemotherapy, radiation therapy, and hormone treatment, respectively. Lymph node dissection was performed in 15 (37.5%) patients (positive rate: 7.4%), 16 (40%) patients underwent omentectomy (positive rate: 10%), and 12 (30%) patients underwent peritoneal lavage cytology (positive rate: 0%). Eighteen (45%) patients had lymphovascular space invasion, 13 (32.5%) patients had uterine fibroids, and 11 (27.5%) patients were diagnosed with endometriosis. Moreover, the levels of CA125 in the serum were measured prior to and following treatment. The median PFS and OS were 9 and 24 months, respectively. Eventually, 29 (72.5%) patients experienced relapse and 19 (47.5%) patients expired due to the disease.ConclusionPatients with advanced HG-ESS (stage II–IV) were associated with poor prognosis. The minimum value of CA125 and endometriosis were independent risk factors for PFS. The stage of disease, size of the tumor, minimum and average values of CA125, menopause, history of uterine leiomyoma, and endometriosis were independent risk factors for OS. The combination of surgery with radiotherapy and chemotherapy may improve the PFS of patients in the early stage of the disease.

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Section: Introductionmentioning

confidence: 99%

<p>High-grade endometrial stromal sarcoma: a retrospective study of factors influencing prognosis</p>

Zhang¹,

Li²,

Qin³

et al. 2019

CMAR

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“…Targeted therapies, [24] especially administration of mTOR inhibitors, seem to provide promising results in recent case reports. [9] Tuberous sclerosis complex (TSC) is characterized by the development of tumors at various sites, including the brain, heart, and kidney.…”

Section: Discussionmentioning

confidence: 99%

Malignant perivascular epithelioid cell tumor in the female genital tract

Liu

Chao

Lin³

et al. 2019

Medicine

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Background:Perivascular epithelioid cell tumor (PEComa) is a rare mesenchymal tumor, located at various anatomic sites, including the female genital tract. This study aimed to evaluate the clinicopathological characteristics of patients with PEComa arising from the female genital tract.Methods:A retrospective study was conducted in Taipei Veterans General Hospital (Taipei VGH) between 2008 and 2018. All published English cases based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement were also included in the current review.Results:A total of 114 women from PRISMA and 3 women from Taipei VGH were identified. The uterus was the most commonly involved site (82/114, 71.9%), followed by the cervix (12/114, 10.5%). Immunohistochemical staining showed that nearly all gynecological PEComas were positive for human melanoma black 45 (113/114, 99.1%). More than half of the gynecological PEComas were immunoreactive for desmin (50/85, 58.8%). Multi-modality treatment, including surgery and mammalian target of rapamycin (mTOR) inhibitors as targeted therapy, provided long-term disease-free survival (cure rate ranging from 50% to 100%, based on the different anatomic sites of the female genital tract).Conclusion:Multi-modality treatment, including cytoreductive surgery and mTOR inhibitors with/without chemotherapy and/or radiation, should be considered for the management of women with PEComas in the genital tract.

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“…On the other side, immunotherapy did not show potential benefits for US. It is our opinion that future genetic research will significantly allow a better identification of the molecular signatures of US, in order to provide the optimal treatment strategy for these malignancies [43][44][45][46][47][48].…”

Section: Discussionmentioning

confidence: 99%

Uterine Sarcomas: An Updated Overview

Zappacosta¹,

Fanfani²,

Zappacosta³

et al. 2018

Neoplasm

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Uterine sarcomas (USs) account for 3-9% of uterine malignant neoplasia and about 5% of all gynaecologic malignancies. Despite their low prevalence, these tumors stimulate a great interest because of their aggressiveness, poor prognosis and high mortality rate. According to the last world health organization (WHO) classification and the International Federation of gynecology and obstetrics committee (FIGO) staging, USs are categorized as pure mesenchymal tumors (endometrial stromal sarcoma, leiomyosarcoma and undifferentiated uterine) and mixed tumors (carcinosarcoma and adenosarcoma). Due to their non-specific signs and symptoms, USs are commonly diagnosed in advanced stage, more often after surgery for a suspected leiomyoma. Although surgery followed by adjuvant therapies represent the common choices for USs, they show poor efficacy due to the early occurrence of metastasis, and the high resistance of tumors to radio-and chemotherapy. Presently, specific expression profiles and new cytotoxic agents are under investigation. In these reviews, we summarized clinical and pathological features, imaging characteristics, therapeutic approaches, genomic and molecular aberration associated with smooth muscle neoplasia (Part 1) and endometrial stromal neoplasia (Part 2); the goal is to understand the biology and the molecular signature of these tumors, in order to focus on their best management.

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Uterine sarcoma part III—Targeted therapy: The Taiwan Association of Gynecology (TAG) systematic review

Cited by 15 publications

References 76 publications

<p>High-grade endometrial stromal sarcoma: a retrospective study of factors influencing prognosis</p>

<p>High-grade endometrial stromal sarcoma: a retrospective study of factors influencing prognosis</p>

Malignant perivascular epithelioid cell tumor in the female genital tract

Uterine Sarcomas: An Updated Overview

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