Uterine cancers (original) (raw)
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Uterine Sarcoma, Version 1.2016
Journal of the National Comprehensive Cancer Network, 2015
The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ®) are a statement of consensus of the authors regarding their views of currently accepted approaches to treatment. The NCCN Guidelines ® Insights highlight important changes to the NCCN Guidelines ® recommendations from previous versions. Colored markings in the algorithm show changes and the discussion aims to further the understanding of these changes by summarizing salient portions of the NCCN Guideline Panel discussion, including the literature reviewed. These NCCN Guidelines Insights do not represent the full NCCN Guidelines; further, the National Comprehensive Cancer Network ® (NCCN ®) makes no representation or warranties of any kind regarding the content, use, or application of the NCCN Guidelines and NCCN Guidelines Insights and disclaims any responsibility for their applications or use in any way. The full and most current version of these NCCN Guidelines are available at NCCN.org.
Experimental and Therapeutic Medicine, 2021
Endometrial stromal sarcoma (ESS) is a rare tumor, predominantly occurring as a primary tumor of the uterus. Rare cases of primary extrauterine ESS (EESS) have been reported. Low-grade ESS (LG-ESS) is more common than high-grade ESS (HG-ESS). We present five cases of ESS and one case of EESS. All cases received external radiotherapy (EBRT) at the Radiotherapy Department of the Emergency Clinical Hospital 'Sfantul Apostol Andrei' Galati, during 2004-2020. Five cases underwent EBRT in two-dimensional (2D) technique and only one patient received EBRT with three-dimensinal conformational radiotherapy (3DCRT) technique with a linear accelerator, Elekta Synergy. Five patients were referred to postoperative radiotherapy after hysterectomy. The median age of the patients was 57.4 years. One patient was referred to radiotherapy with palliative intent. EESS localized in the retroperitoneum, in the para-aortic region, was identified in one 64-year-old patient with a personal history of hysterectomy and bilateral salpingo-oophorectomy in 1997; EESS was complicated with vertebral extension at the L1-L2 level and spinal cord compression syndrome. ESS represents a rare diagnosis and a high-or low-grade tumor profile is distinguished by immunohistochemistry (IHC) tests. Up to 30% of patients have EESS at presentation. The treatment of ESS is multimodal, its management requiring a multidisciplinary team, and it is different according to the primary tumor location and tumor staging. The role of adjuvant radiotherapy remains controversial in high-grade EESS and due to the rarity of these cases there are limited data concerning the efficacy of adjuvant EBRT available from prospective randomized control clinical trials.
Uterine sarcoma Part II-Uterine endometrial stromal sarcoma: The TAG systematic review
Taiwanese journal of obstetrics & gynecology, 2016
Endometrial stromal tumors are rare uterine tumors (<1%). Four main categories include endometrial stromal nodule, low-grade endometrial stromal sarcoma (LG-ESS), high-grade endometrial stromal sarcoma (HG-ESS), and uterine undifferentiated sarcoma (UUS). This review is a series of articles discussing the uterine sarcomas. LG-ESS, a hormone-dependent tumor harboring chromosomal rearrangement, is an indolent tumor with a favorable prognosis, but characterized by late recurrences even in patients with Stage I disease, suggesting the requirement of a long-term follow-up. Patients with HG-ESS, based on the identification of YWHAE-NUTM2A/B (YWHAE-FAM22A/B) gene fusion, typically present with advanced stage diseases and frequently have recurrences, usually within a few years after initial surgery. UUS is, a high-grade sarcoma, extremely rare, lacking a specific line of differentiation, which is a diagnosis of exclusion (the wastebasket category, which fails to fulfill the morphological...
Clinicopathologic analysis of uterine sarcomas from a single institution in the
2009
To evaluate the clinicopathologic data and prognostic factors for patients with uterine sarcomas treated at a single institution, with special emphasis on malignant mixed müllerian tumors (MMMT). Methods: Medical and anatomic pathology records were reviewed. Survival rates were analyzed using the Kaplan-Meier method. Results: The study included 89 patients: 48.4% with MMMT; 22.4% with leiomyosarcomas; 20.2% with endometrial stromal sarcomas; and 9% with adenosarcomas. FIGO stages I, II, III, and IV were identified in 57.3%, 9.0%, 22.5%, and 7.8% of patients respectively. Event-free survival rates after 2, 5, and 10 years were 70%, 61%, and 55% respectively, with a median time of 90 months (95% CI, 41-140 months). Overall survival rates after 2, 5, and 10 years were 50%, 45%, and 39% respectively, with a median time of 43 months (95% CI, 3-83 months). Multivariate analysis showed that stage, histology, tumor size, and parity had an independent influence on overall survival. Conclusions: MMMT are the most aggressive tumors and their behavior strongly resembles that of highgrade endometrial adenocarcinoma. Prognostic factors affecting survival were stage, histology, tumor size, and parity.
Geburtshilfe und Frauenheilkunde, 2019
Aims This is an official guideline published and coordinated by the German Society of Gynecology and Obstetrics (DGGG) and the Austrian Society of Gynecology and Obstetrics (OEGGG). Because of their rarity and heterogeneous histopathology, uterine sarcomas are challenging in terms of how they should be managed clinically, and treatment requires a multidisciplinary approach. To our knowledge, there are currently no binding evidence-based recommendations for the appropriate management of this heterogeneous group of tumors. Methods This S2k guideline was first published in 2015. The update published here is the result of the consensus of a representative interdisciplinary group of experts who carried out a systematic search of the literature on uterine sarcomas in the context of the guidelines program of the DGGG, OEGGG and SGGG. Members of the participating professional societies achieved a formal consensus after a moderated structured consensus process. Recommendations The consensus-...
2021
Background/Aim: Uterine sarcomas are rare and aggressive tumors, and their clinical behavior is unpredictable. A clear-cut clinical course, proven treatment method or definitive prognostic factors affecting the survival of sarcoma patients are not reported in the literature. We aim to evaluate uterine sarcomas, determine clinicopathologic features, adjuvant therapies, and prognostic factors on survival while sharing our experience of these rare uterine tumors in light of the literature. Methods: This retrospective cohort study was conducted in Tepecik Training and Research Hospital, Izmir, Turkey between 2002-2020. Out of the total of 205 uterine sarcoma patients, 173 patients who underwent surgical procedures and were followed up in our hospital's Gynecologic Oncology Clinic were included in the study. Data of patients were collected from the hospital database. Surgical interventions, clinicopathologic features, adjuvant therapies, and overall and disease-free survivals were evaluated. Patients were grouped as leiomyosarcoma (LMS), carcinosarcoma (CS), endometrial stromal sarcoma (ESS), adenosarcoma (AS), and undifferentiated sarcoma (US). Results: The mean age of the patients was 57.6 (11.2) years. According to the International Federation of Gynecology and Obstetrics (FIGO2009), 115 patients (66.5%) had stage 1, 17 patients (9.8%) had stage 2, 31 (17.9%) patients had stage 3, and 10 patients (5.8%) had stage 4 disease. One hundred and sixty-two patients (93.6%) received adjuvant therapy. Median follow-up period was 39 months (range 3-214). The 120-month OS for the entire group was 87.1%. Conclusion: Stage is a significant prognostic factor for survival in all sarcoma types and recurrence is a significant prognostic factor for survival for LMS and CS patients. Sarcoma type and adjuvant treatments have no impact on survival. ESS patients require extended surgical staging.
Endometrial stromal sarcoma: prognostic factors and impact of adjuvant therapy in early stages
Hematology/Oncology and Stem Cell Therapy, 2012
E ndometrial stromal sarcomas (ESS) are rare uterine neoplasms. Conventionally divided into high and low grade by histological aspect and mitotic activity, high-grade tumors are currently included in undiferentiated uterine sarcoma (and low-grade ESS is what is referred to as ESS currently). Surgery remains the cornerstone of treatment for localized stages and consists of an abdominal hysterectomy with bilateral salpingo-oopherectomy, however, the relapse rate remains high (18%-45%) and might be improved by adjuvant therapy not yet well deined. We conducted this study investigate the prognostic factors for relapse and to review the impact of adjuvant therapy.