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World J Clin Cases. Jul 26, 2019; 7(14): 1753-1763
Published online Jul 26, 2019. doi: 10.12998/wjcc.v7.i14.1753
Current status of the adjuvant therapy in uterine sarcoma: A literature review
Alessandro Rizzo, Maria Abbondanza Pantaleo, Maristella Saponara, Margherita Nannini
Alessandro Rizzo, Maria Abbondanza Pantaleo, Maristella Saponara, Margherita Nannini, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna 40138, Italy
Author contributions: Rizzo A and Pantaleo MA designed research; Rizzo A and Saponara M performed research; Rizzo A and Nannini M analyzed data; Rizzo A, Pantaleo MA and Nannini M wrote the paper.
Conflict-of-interest statement: No conflict to interest to declare by all authors.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Margherita Nannini, MD, Academic Research, Doctor, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Via Massarenti 9, Bologna 40138, Italy. margherita.nannini@unibo.it
Telephone: +39-51-2143819 Fax: +39-51-6363815
Received: March 12, 2019
Peer-review started: March 20, 2019
First decision: May 13, 2019
Revised: May 16, 2019
Accepted: June 26, 2019
Article in press: June 26, 2019
Published online: July 26, 2019
Processing time: 139 Days and 1.8 Hours
Abstract

Uterine sarcomas (US) are rare mesenchymal tumours accounting approximately for 3%–7% of all uterine cancers. Histologically, US are classified into mesenchymal tumours or mixed epithelial and mesenchymal tumours. The group of mesenchymal tumours includes uterine leiomyosarcoma (uLMS, 65% of cases), endometrial stromal sarcoma (ESS, 21%) – traditionally divided into low grade (LG-ESS) and high grade–undifferentiated uterine sarcoma (5%) and other rare subtypes such as alveolar or embryonal rhabdomyosarcoma. Despite the fact that several drugs demonstrated clinical activity in advanced or metastatic settings, the role of postoperative therapy in US remains controversial. In this review, we have summarised the current state of the art, including the chief trials on adjuvant treatment modalities in US, especially focusing on uLMS, LG-ESS and other rare histotypes.

Keywords: Uterine sarcoma; Uterine leiomyosarcoma; Endometrial stromal sarcoma; Adenosarcoma; Adjuvant therapy; Chemotherapy; Radiotherapy

Core tip: Uterine sarcomas (US) comprise a group of rare mesenchymal tumours with differing tumour biology, natural history and response to treatment. Clinical trials have shown no definite survival benefit of postoperative treatment (neither chemotherapy, nor radiation, nor hormone blockade) although its use seems reasonable in selected cases. This review aims to summarise the current state of knowledge about adjuvant therapy in US.