Abstract：
:Uterine leiomyosarcoma is the most common type of uterine sarcoma. It is an extremely aggressive malignancy associated with a poor overall prognosis. Women affected may vary in age, but are most often diagnosed in their perimenopausal years. Presenting symptoms may be vague and mimic other benign uterine conditions. Preoperative diagnosis of leiomyosarcoma is difficult and often only made at time of surgical resection. These rare mesenchymal tumors are characterized by cytologic atypia, a high mitotic index, and tumor necrosis on histologic inspection. Management of early stage disease entails hysterectomy and complete surgical resection of gross tumor, though routine oophorectomy or lymph node dissection do not appear to confer much clinical benefit. Adjuvant therapy for early stage disease remains controversial as multiple clinical trials have failed to demonstrate benefit on overall survival. Recently, progress has been made in regards to therapy for advanced and recurrent disease. Novel chemotherapeutics, targeted therapies such as olaratumab and pazopanib, and new immunotherapies such as nivolumab and pembrolizumab have demonstrated promise in these previously difficult drug-resistant patients. In this article, we provide a detailed review of uterine leiomyosarcoma including epidemiology, clinical presentation, diagnosis, and pathologic characteristics. We then go on detail management strategies, including options for adjuvant therapy, and highlight new and developing regimens in the field.
journal_name
Gynecol Oncoljournal_title
Gynecologic oncologyauthors
Roberts ME,Aynardi JT,Chu CSdoi
10.1016/j.ygyno.2018.09.010subject
Has Abstractpub_date
2018-12-01 00:00:00pages
562-572issue
3eissn
0090-8258issn
1095-6859pii
S0090-8258(18)31221-6journal_volume
151pub_type
杂志文章,评审abstract：:Treatment of 102 patients with cancer of the cervix by class II and III radical hysterectomy was reviewed to compare the operative morbidity and efficacy of class II radical hysterectomy for select cases. Of the 102 patients, 21 had a class II hysterectomy, whereas 81 patients had a class III hysterectomy. The class I...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1016/0090-8258(91)90078-j
更新日期：1991-01-01 00:00:00
abstract：:Adenocarcinoma of the cervix represents an increasing percentage of cervical cancers as well as a controversial clinical problem. One hundred seventy-two cases of adenocarcinoma were treated at The University of Michigan Medical Center from 1970 to 1984, representing 16.8% of cervical cancers. Of this group 84 patient...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1016/0090-8258(87)90231-9
更新日期：1987-05-01 00:00:00
abstract：OBJECTIVE:To evaluate clinical outcomes of patients with BRCA-associated ovarian cancer who developed brain metastases (BM). METHODS:Patients with epithelial ovarian, fallopian tube, and primary peritoneal cancer (EOC) and BM, treated at a single institution from 1/1/2008-7/1/2018, were identified from two institution...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1016/j.ygyno.2019.05.004
更新日期：2019-07-01 00:00:00
abstract：OBJECTIVE:The presence of metastases to regional lymph nodes (LN) is the single most important risk factor in endometrial cancer. Advances in molecular biology have provided more sensitive methods for detecting micrometastasis. This was a pilot study to determine whether cytokeratin staining of LN from endometrial canc...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1016/j.ygyno.2003.08.026
更新日期：2003-12-01 00:00:00
abstract：OBJECTIVE:In a previous study using the same cases of squamous cervical neoplasia and microinvasive carcinoma (MICA) we found an association between FHIT gene deletion and infection with high-risk HPV (HR HPV). The purpose of this study was to evaluate Fhit protein expression by immunohistochemistry in order to determi...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1006/gyno.2002.6712
更新日期：2002-08-01 00:00:00
abstract：OBJECTIVE:Inappropriate telomerase expression has been reported to be associated with the development and/or progression of malignancies. Therefore, the purpose of the study was to determine and evaluate the levels of telomerase activity in normal ovary, cystadenomas, low-malignant-potential tumors, and carcinomas of t...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1006/gyno.1999.5506
更新日期：1999-09-01 00:00:00
abstract：INTRODUCTION:Vulvar squamous cell carcinoma (VSCC) commonly metastasises through groin lymphatics. However, the use of pre-operative imaging in detecting inguinal nodal metastasis before staging surgery or to triage patients for sentinel node biopsy remains unclear. Here, we investigated if pre-operative CT scan, the i...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1016/j.ygyno.2020.01.031
更新日期：2020-05-01 00:00:00
abstract：OBJECTIVE:This study describes the surgical treatment and follow-up of 213 patients with primary vulvar cancer; particular attention is given to reconstructive surgical procedures. METHODS:The clinical and pathological parameters of the patients were recorded according to standardized procedures, and the data concerni...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1016/j.ygyno.2005.05.031
更新日期：2005-10-01 00:00:00
abstract：OBJECTIVE:To examine the DNA methyltransferase (DNMT) mRNA and protein levels in endometrioid and serous cancers and to study the relationship between DNA methyltransferase expression and endometrial cancer development. METHODS:Normal endometrium, Grade I and Grade III endometrioid carcinoma tissues and cell lines, as...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1016/j.ygyno.2004.11.047
更新日期：2005-03-01 00:00:00
abstract：OBJECTIVE:Molecular chaperone 78 kDa glucose-regulated protein (GRP78) is a residential protein in the endoplasmic reticulum (ER) that is induced by an unfolded-protein response triggered under many kinds of stress against a cell. GRP78 is also known to act as an anti-apoptotic factor by protecting ER-stress-induced ce...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1016/j.ygyno.2012.04.025
更新日期：2012-07-01 00:00:00
abstract：OBJECTIVE:The aim of this study was to assess the survival benefit of salvage surgical cytoreduction in patients with recurrent ovarian cancer and compare the surgical outcome with salvage chemotherapy alone. METHODS:Seventy-five patients with recurrent ovarian cancer were reviewed for possible benefits of salvage the...
journal_title：Gynecologic oncology
pub_type： 杂志文章,多中心研究
doi：10.1016/j.ygyno.2004.11.057
更新日期：2005-04-01 00:00:00
abstract：:A double complete and prolonged response of metastatic endometrial carcinoma to medroxyprogesterone is reported. A 61-year-old woman with metastatic endometrial carcinoma in lung and liver achieved a complete clinical response with medroxyprogesterone lasting for 2 years. She discontinued the therapy by herself and de...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1006/gyno.1998.5229
更新日期：1999-02-01 00:00:00
abstract：BACKGROUND:The simultaneous occurrence of advanced cervical cancer and a pelvic kidney is uncommonly reported. It is an interesting clinical problem because the pelvic kidney lies within the radiation field. CASE:A patient found to have bilateral pelvic kidneys and stage II-B cervical cancer underwent an anterior exen...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1016/j.ygyno.2003.09.033
更新日期：2004-01-01 00:00:00
abstract：:Only one case of endometrial transitional cell carcinoma (TCC) has been previously reported in the literature. We report a second case. In both the previously reported case and in this case there was a separate focus of TCC in the adnexa. Both patients were treated with adjuvant whole pelvic radiation and are alive an...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1006/gyno.1996.0047
更新日期：1996-02-01 00:00:00
abstract：:The purpose of this study was to determine the influence of tumor grade, distribution, and extent of carcinomatosis in minimal residual epithelial ovarian cancer after primary optimal cytoreductive surgery. Between 1978 and 1990, 112 patients with stage III epithelial ovarian cancer underwent primary cytoreductive sur...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1006/gyno.1994.1257
更新日期：1994-10-01 00:00:00
abstract：:An estimated 2-5% of endometrial cancers and 15-20% of high-grade, non-mucinous epithelial ovarian cancers have an underlying hereditary cause. Appropriate risk assessment, genetic counseling, and germline genetic testing for cancer predisposition genes in both gynecologic cancer patients and their at-risk relatives i...
journal_title：Gynecologic oncology
pub_type： 杂志文章,评审
doi：10.1016/j.ygyno.2019.01.024
更新日期：2019-04-01 00:00:00
abstract：:A total of 246 endocervical samples were collected for Papanicolaou staining and one-parameter flow cytometric DNA analysis (FCDA) using 4',6-diamidino-2-phenylindole as a DNA stain. Typical histograms derived from FCDA analysis were designated class I, II, III, and V. Two groups of patients were studied: 135 women re...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1016/0090-8258(83)90049-5
更新日期：1983-06-01 00:00:00
abstract：OBJECTIVE:Lymphadenectomy is an integral part of staging and treatment of gynecologic malignancies. We evaluated the feasibility and oncologic value of laparoscopic transperitoneal pelvic and paraaortic lymphadenectomy in correlation to complication rate and body mass index. METHODS:Between August 1994 and September 2...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1016/j.ygyno.2004.07.025
更新日期：2004-10-01 00:00:00
abstract：OBJECTIVE:The goal of this study was to determine if three-dimensional power Doppler ultrasound improves the specificity for ovarian cancer detection as compared with two-dimensional ultrasound. METHODS:Seventy-one women with a known complex pelvic mass were referred for a preoperative ultrasound evaluation with both ...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1006/gyno.2001.6253
更新日期：2001-07-01 00:00:00
abstract：:Breast cancer is the leading cause of cancer death in women. Ovarian cancer, although less frequent, is detected very late, and survival is correlated to early detection. Therefore, better methods for early detection would help to increase the number of survivors. The incidence of young women diagnosed with breast can...
journal_title：Gynecologic oncology
pub_type： 杂志文章,评审
doi：10.1016/j.ygyno.2009.10.079
更新日期：2010-05-01 00:00:00
abstract：OBJECTIVE:To evaluate safety, tolerability, and antitumor activity of pembrolizumab monotherapy in patients with programmed death ligand 1 (PD-L1)-expressing advanced ovarian cancer enrolled in the multicohort, phase Ib KEYNOTE-028 trial. METHODS:Key inclusion criteria were age ≥18 years; advanced ovarian epithelial, ...
journal_title：Gynecologic oncology
pub_type： 杂志文章,多中心研究
doi：10.1016/j.ygyno.2018.11.017
更新日期：2019-02-01 00:00:00
abstract：:From 1978 to 1982, 49 patients with intraepithelial neoplasia in the vulvar region were included in a prospective investigation. The main purpose was to evaluate the effect of treatment by local excision with a free margin of 2 mm and to estimate the importance of colposcopy. In 28% of the patients, the disease recurr...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1016/0090-8258(85)90267-7
更新日期：1985-07-01 00:00:00
abstract：:Sixty-eight patients with FIGO stage I, grade 2 or 3 adenocarcinoma of the endometrium were treated according to a protocol involving 10 Gy external pelvic irradiation, prompt hysterectomy with surgical staging, and postoperative therapy individualized according to surgical-pathologic findings. Five-year survival for ...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1016/0090-8258(86)90222-2
更新日期：1986-02-01 00:00:00
abstract：OBJECTIVE:The identification and investigation of cancer-associated long non-coding RNAs are important for understanding the molecular biology of cancer. The aim of the present study was to examine the expression pattern of lncRNA XLOC_010588 in cervical cancer and to evaluate its biological role and clinical significa...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1016/j.ygyno.2014.03.555
更新日期：2014-06-01 00:00:00
abstract：BACKGROUND:Carcinoma of the cervix and a prolapsed uterus are common diseases in underdeveloped countries, but their association is quite rare. CASE:We report here the clinical characteristics of two Brazilian patients with carcinoma of the uterine cervix associated with a third-degree prolapsed uterus. The patients, ...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1006/gyno.2001.6503
更新日期：2002-02-01 00:00:00
abstract：:Clinical research in gynecologic oncology has seen a proliferation of studies that investigate the effectiveness of treatments using existing data sources such as cancer registries, electronic health records, and insurance claims. These observational studies are often feasible when randomized trial may not be, and may...
journal_title：Gynecologic oncology
pub_type： 杂志文章,评审
doi：10.1016/j.ygyno.2018.11.006
更新日期：2019-03-01 00:00:00
abstract：OBJECTIVE:To correlate findings on pathologic examination of loop electroexcisional procedure (LEEP) or cone biopsy specimens with residual disease in radical hysterectomy specimens in patients with stage IA2 cervical cancer to determine whether a subset of such patients may be eligible for conservative, fertility-spar...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1016/j.ygyno.2008.09.011
更新日期：2009-01-01 00:00:00
abstract：OBJECTIVE:To assess the incidence of vulvar high-grade precancerous lesions and cancer in Denmark during 1997-2018. METHODS:We identified incident vulvar cancer cases in the Danish Cancer Registry and incident cases of vulvar precancerous lesions in the Danish Pathology Register. We calculated age-standardized inciden...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1016/j.ygyno.2020.03.030
更新日期：2020-06-01 00:00:00
abstract：:This study evaluated the effect ovarian weight has on the accuracy of frozen sections in serous and mucinous ovarian tumors. The study group included 294 patients who had an initial frozen section (189 serous and 105 mucinous tumors) at surgery. The pathology reports were separated into subgroups (benign, borderline, ...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1006/gyno.1997.4836
更新日期：1997-10-01 00:00:00
abstract：OBJECTIVE:The goal of this study was to evaluate the interexaminer variation in the assessment of postmenopausal ovaries using transvaginal ultrasound (TVU). METHODS:One hundred eighty-eight cancer screening trial participants undergoing TVU were reassessed by a second TVU examination. RESULTS:Although first examiner...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1006/gyno.2000.5785
更新日期：2000-05-01 00:00:00
