Italian consensus conference on management of uterine sarcomas on behalf of S.I.G.O. (Societa' italiana di Ginecologia E Ostetricia).
Eur J Cancer
; 139: 149-168, 2020 11.
Article
em En
| MEDLINE
| ID: mdl-32992154
ABSTRACT
BACKGROUND:
Uterine sarcomas are very rare tumours with different histotypes, molecular features and clinical outcomes; therefore, it is difficult to carry out prospective clinical trials, and this often results in heterogeneous management of patients in the clinical practice.AIM:
We planned to set up an Italian consensus conference on these diseases in order to provide recommendations on treatments and quality of care in our country.RESULTS:
Early-stage uterine sarcomas are managed by hysterectomy + bilateral salpingo-oophorectomy according to menopausal status and histology; lymphadenectomy is not indicated in patients without bulky nodes, and morcellation must be avoided. The postoperative management is represented by observation, even though chemotherapy can be considered in some high-risk patients. In early-stage low-grade endometrial stromal sarcoma and adenosarcomas without sarcomatous overgrowth, hormonal adjuvant treatment can be offered based on hormone receptor expression. In selected cases, external beam radiotherapy ± brachytherapy can be considered to increase local control only. Patients with advanced disease involving the abdomen can be offered primary chemotherapy (or hormonal therapy in the case of low-grade endometrial stromal sarcoma and adenosarcoma without sarcomatous overgrowth), even if potentially resectable in the absence of residual disease in order to test the chemosensitivity (or hormonosensitivity); debulking surgery can be considered in patients with clinical and radiological response. Chemotherapy is based on anthracyclines ± ifosfamide or dacarbazine. Palliative radiotherapy can be offered for symptom control, and stereotactic radiotherapy can be used for up to five isolated metastatic lesions.CONCLUSIONS:
Treatment of uterine sarcoma should be centralised at referral centres and managed in a multidisciplinary setting.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
/
Prevencao_e_fatores_de_risco
/
Agentes_cancerigenos
/
Tipos_de_cancer
/
Outros_tipos
/
Tratamento
/
Radioterapia
Base de dados:
MEDLINE
Assunto principal:
Sarcoma
/
Neoplasias Uterinas
/
Antineoplásicos
Tipo de estudo:
Guideline
Limite:
Female
/
Humans
País/Região como assunto:
Europa
Idioma:
En
Revista:
Eur J Cancer
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Itália