Others Sarcomas

Sarcomas of the Endometrium

Tumor Types

Malignant Mixed Mullerian Tumors (Carcinosarcoma)

  • metastasize as adenocarcinoma of endometrium
  • usually has history of prior RT

Leiomyosarcomas

  • locally recur after resection
  • > 50% metastasize to distant organs: lungs, bone, and brain
  • OS-5 40%
  • anaplastic variants have OS-5 of 10-15%

Endometrial Stromal Tumors

  • comes in 3 different grades
  1. Benign
  2. low-grad or endolymphatic stromal myosis
  3. endometrial stromal sarcoma
    • invasive vessels and are capable of widespread metastasis

Treatment

  • Doxorubicin effective in childhood and adult sarcomas of extrauterine origin
  • Doxorubicin has 8-25% response rate
  • Other drugs such as dacrabazine, cyclophosphamide, ifosfamide have not added substantially

Results
* OS-5 50%

Treatment

Surgery

  • Hysterectomy should be attempted
  • Hysterectomy is curative for tumors confined to the uterus

Radiation

  • No prospective randomized trial
  • Most studies report better pelivc control, particularly in stage I and II
  • Impact on survival has been mixed, with benefit seen in some but not all.

Chemotherapy

  • One randomized study of Stage I and II uterine sarcomas was not significant for the adjuvant chemotherapy group.
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