Skip to main content
Erschienen in: Current Oncology Reports 6/2013

01.12.2013 | Gynecologic Cancers (NS Reed, Section Editor)

A Review of Treatment of Uterine Leiomyosarcomas

verfasst von: Nicholas Reed

Erschienen in: Current Oncology Reports | Ausgabe 6/2013

Einloggen, um Zugang zu erhalten

Abstract

Uterine leiomyosarcomas are rare but challenging tumours. They occur most commonly around or shortly after the menopause. Their clinical behaviour is very variable, from highly aggressive to very indolent. Most are diagnosed unexpectedly and thus initially operated on by general gynaecologists. This article discusses the important surgical issues and the role of adjuvant treatments such as radiotherapy and chemotherapy. Important new international trials are opening to address these issues. Relapsed disease is usually incurable, but a subgroup of patients may benefit from repeated surgical procedures, hormones and ablative therapies. The choice of drugs for chemotherapy is discussed. New approaches with targeted agents have yet to establish themselves in treatment of leiomyosarcomas.
Literatur
1.
Zurück zum Zitat Dinh TA, Woodruff JD. Leiomyosarcoma of the uterus. Am J Obstet Gynecol. 1982;144:817–23.PubMed Dinh TA, Woodruff JD. Leiomyosarcoma of the uterus. Am J Obstet Gynecol. 1982;144:817–23.PubMed
2.
Zurück zum Zitat Schwartz LB, Diamond MP, Schwartz MP. Leiomyosarcomas: clinical presentation. Am J Obstet Gynecol. 1993;168:180–3.PubMedCrossRef Schwartz LB, Diamond MP, Schwartz MP. Leiomyosarcomas: clinical presentation. Am J Obstet Gynecol. 1993;168:180–3.PubMedCrossRef
3.
Zurück zum Zitat Brooks SE, Zhan M, Baquet C. Surveillance, epidemiology, and end results analysis of 2677 cases of uterine sarcoma 1989–1999. Gynecol Oncol. 2004;93:204–8.PubMedCrossRef Brooks SE, Zhan M, Baquet C. Surveillance, epidemiology, and end results analysis of 2677 cases of uterine sarcoma 1989–1999. Gynecol Oncol. 2004;93:204–8.PubMedCrossRef
4.
Zurück zum Zitat Evans HL, Chawla SP, Simpson C, Finn KP. Smooth muscle neoplasms of the uterus other than ordinary leiomyoma. A study of 46 cases with emphasis on diagnostic criteria and prognostic factors. Cancer. 1988;62:2239–47.PubMedCrossRef Evans HL, Chawla SP, Simpson C, Finn KP. Smooth muscle neoplasms of the uterus other than ordinary leiomyoma. A study of 46 cases with emphasis on diagnostic criteria and prognostic factors. Cancer. 1988;62:2239–47.PubMedCrossRef
5.
Zurück zum Zitat Bell SW, Kempson RL, Hendrickson MR. Problematic uterine smooth muscle neoplasms: a clinicopathological study of 213 cases. Am J Surg Pathol. 1994;18:535–58.PubMedCrossRef Bell SW, Kempson RL, Hendrickson MR. Problematic uterine smooth muscle neoplasms: a clinicopathological study of 213 cases. Am J Surg Pathol. 1994;18:535–58.PubMedCrossRef
6.
Zurück zum Zitat Hendrickson M, Longacre T, Kempson R. Pathology of uterine sarcomas. In: Coukos G, Rubin SC, editors. Cancers of uterus. New York: Dekker; 2005. p. 149–95. Hendrickson M, Longacre T, Kempson R. Pathology of uterine sarcomas. In: Coukos G, Rubin SC, editors. Cancers of uterus. New York: Dekker; 2005. p. 149–95.
7.
Zurück zum Zitat • Mehine M, Kaasinen E, Makinen N, Katainen R, Kampjarvi K, Pitkanen E, et al. Characterisation of uterine leiomyomas by whole-genome sequencing. N Engl J Med. 2013. doi:10.1056/NEJMoal1302736. Interesting article helping to evaluate potential new targets. • Mehine M, Kaasinen E, Makinen N, Katainen R, Kampjarvi K, Pitkanen E, et al. Characterisation of uterine leiomyomas by whole-genome sequencing. N Engl J Med. 2013. doi:10.​1056/​NEJMoal1302736. Interesting article helping to evaluate potential new targets.
8.
Zurück zum Zitat • Farid M, Ong WS, Tan MH, et al. The influence of primary site on outcomes in leiomyosarcoma: a review of clinicopathologic differences between uterine and extra-uterine disease. Am J Clin Oncol. 2013;36:368–74. Useful article on differences between uterine and extra-uterine tumours. • Farid M, Ong WS, Tan MH, et al. The influence of primary site on outcomes in leiomyosarcoma: a review of clinicopathologic differences between uterine and extra-uterine disease. Am J Clin Oncol. 2013;36:368–74. Useful article on differences between uterine and extra-uterine tumours.
9.
Zurück zum Zitat Leibsohn S, d’Ablaing G, Misell DR, Schlaerth JB. Leiomyosarcoma in a series of hysterectomies performed for presumed uterine leiomyomas. Am J Obstet Gynecol. 1990;162:968–74.PubMedCrossRef Leibsohn S, d’Ablaing G, Misell DR, Schlaerth JB. Leiomyosarcoma in a series of hysterectomies performed for presumed uterine leiomyomas. Am J Obstet Gynecol. 1990;162:968–74.PubMedCrossRef
10.
Zurück zum Zitat Shah SH, Jagannathan JP, Krajewski K, O’Regan KN, George S, Ramaiya NH. Uterine sarcomas: then and now. AJR Am J Roentgenol. 2012;199:213–23.PubMedCrossRef Shah SH, Jagannathan JP, Krajewski K, O’Regan KN, George S, Ramaiya NH. Uterine sarcomas: then and now. AJR Am J Roentgenol. 2012;199:213–23.PubMedCrossRef
11.
Zurück zum Zitat Amant F. The rationale for comprehensive surgical staging in endometrial carcinosarcoma. Gynecol Oncol. 2005;99(2):521–2.PubMedCrossRef Amant F. The rationale for comprehensive surgical staging in endometrial carcinosarcoma. Gynecol Oncol. 2005;99(2):521–2.PubMedCrossRef
12.
Zurück zum Zitat Major FJ, Blessing JA, Silverberg SG, Morrow CP, Creasman WT, Currie JL, et al. Prognostic factors in early-stage uterine sarcoma. A Gynecologic Oncology Group study. Cancer. 1993;71:1702–9.PubMedCrossRef Major FJ, Blessing JA, Silverberg SG, Morrow CP, Creasman WT, Currie JL, et al. Prognostic factors in early-stage uterine sarcoma. A Gynecologic Oncology Group study. Cancer. 1993;71:1702–9.PubMedCrossRef
13.
Zurück zum Zitat Goff BA, Rice LW, Fleischhacker D, et al. Uterine leiomyosarcoma and endometrial stromal sarcoma: lymph node metastases and sites of recurrence. Gynecol Oncol. 1993;50:105–9.PubMedCrossRef Goff BA, Rice LW, Fleischhacker D, et al. Uterine leiomyosarcoma and endometrial stromal sarcoma: lymph node metastases and sites of recurrence. Gynecol Oncol. 1993;50:105–9.PubMedCrossRef
14.
Zurück zum Zitat Oláh KS, Dunn JA, Gee H. Leiomyosarcomas have a poorer prognosis than mixed mesodermal tumours when adjusting for known prognostic factors: the result of a retrospective study of 423 cases of uterine sarcoma. Br J Obstet Gynaecol. 1992;99(7):590–4.PubMedCrossRef Oláh KS, Dunn JA, Gee H. Leiomyosarcomas have a poorer prognosis than mixed mesodermal tumours when adjusting for known prognostic factors: the result of a retrospective study of 423 cases of uterine sarcoma. Br J Obstet Gynaecol. 1992;99(7):590–4.PubMedCrossRef
15.
Zurück zum Zitat Dinh TA, Oliva EA, Fuller AF, Lee H, Goodman A. The treatment of uterine leiomyosarcoma. Results from a 10 year experience (1990–1999) at Massachusetts General Hospital. Gynecol Oncol. 2004;92:648–52.PubMedCrossRef Dinh TA, Oliva EA, Fuller AF, Lee H, Goodman A. The treatment of uterine leiomyosarcoma. Results from a 10 year experience (1990–1999) at Massachusetts General Hospital. Gynecol Oncol. 2004;92:648–52.PubMedCrossRef
16.
Zurück zum Zitat Gadducci A, Landoni F, Sartori E, Zola P, Maggino T, Lissoni A, et al. Uterine leiomyosarcoma: analysis of treatment failures and survival. Gynecol Oncol. 1996;62:25–32.PubMedCrossRef Gadducci A, Landoni F, Sartori E, Zola P, Maggino T, Lissoni A, et al. Uterine leiomyosarcoma: analysis of treatment failures and survival. Gynecol Oncol. 1996;62:25–32.PubMedCrossRef
17.
Zurück zum Zitat Giuntoli RL, Metzinger DS, DiMarco CS, et al. Retrospective review of 208 patients with leiomyosarcoma of the uterus: prognostic indicators, surgical management, and adjuvant therapy. Gynecol Oncol. 2003;89:460–9.PubMedCrossRef Giuntoli RL, Metzinger DS, DiMarco CS, et al. Retrospective review of 208 patients with leiomyosarcoma of the uterus: prognostic indicators, surgical management, and adjuvant therapy. Gynecol Oncol. 2003;89:460–9.PubMedCrossRef
18.
Zurück zum Zitat Yoshida Y, Kurokawa K, Sawamura Y, et al. Comparison of 18FDG PET and MRI in Assesment of Uterine Smooth Muscle Tumours. J Nuclear Med. 2008;49:708-12. Yoshida Y, Kurokawa K, Sawamura Y, et al. Comparison of 18FDG PET and MRI in Assesment of Uterine Smooth Muscle Tumours. J Nuclear Med. 2008;49:708-12.
19.
Zurück zum Zitat Prayson RA, Goldblum JR, Hart WR. Epithelioid smooth-muscle tumors of the uterus: a clinicopathologic study of 18 patients. Am J Surg Pathol. 1997;21(4):383–91.PubMedCrossRef Prayson RA, Goldblum JR, Hart WR. Epithelioid smooth-muscle tumors of the uterus: a clinicopathologic study of 18 patients. Am J Surg Pathol. 1997;21(4):383–91.PubMedCrossRef
20.
Zurück zum Zitat Reichardt P. The treatment of uterine sarcomas. Ann Oncol. 2012;23 Suppl 10:151–7.CrossRef Reichardt P. The treatment of uterine sarcomas. Ann Oncol. 2012;23 Suppl 10:151–7.CrossRef
21.
Zurück zum Zitat Tierney JF, Mosseri V, Stewart LA, Souhami R, Parmar MK. Adjuvant chemotherapy for soft-tissue sarcoma: review and meta-analysis of the published results of randomised clinical trials. Br J Cancer. 1995;72(2):469–75.PubMedCrossRef Tierney JF, Mosseri V, Stewart LA, Souhami R, Parmar MK. Adjuvant chemotherapy for soft-tissue sarcoma: review and meta-analysis of the published results of randomised clinical trials. Br J Cancer. 1995;72(2):469–75.PubMedCrossRef
22.
Zurück zum Zitat Bramwell VHC. Adjuvant chemotherapy for adult soft tissue sarcoma. Is there a standard of care? J Clin Oncol. 2001;19:1235–7.PubMed Bramwell VHC. Adjuvant chemotherapy for adult soft tissue sarcoma. Is there a standard of care? J Clin Oncol. 2001;19:1235–7.PubMed
23.
Zurück zum Zitat Frustaci S, Gherlinzoni F, De Paoli A, Bonetti M, Azzarelli A, Comandone A, et al. Adjuvant chemotherapy for adult soft tissue sarcomas of the extremities and girdles: results of the Italian randomized cooperative trial. J Clin Oncol. 2001;19:1238–47.PubMed Frustaci S, Gherlinzoni F, De Paoli A, Bonetti M, Azzarelli A, Comandone A, et al. Adjuvant chemotherapy for adult soft tissue sarcomas of the extremities and girdles: results of the Italian randomized cooperative trial. J Clin Oncol. 2001;19:1238–47.PubMed
24.
Zurück zum Zitat Omura GA, Blessing JA, Major F, et al. A randomized clinical trial of adjuvant adriamycin in uterine sarcomas: a Gynecologic Oncology Group study. J Clin Oncol. 1985;3(9):1240–5.PubMed Omura GA, Blessing JA, Major F, et al. A randomized clinical trial of adjuvant adriamycin in uterine sarcomas: a Gynecologic Oncology Group study. J Clin Oncol. 1985;3(9):1240–5.PubMed
25.
Zurück zum Zitat Muss H, Omura GA, Blessing JA, Major FJ, Lifshitz S, Mangan C, et al. A randomized clinical trial of adjuvant adriamycin in uterine sarcomas: a Gynecologic Oncology Group study. J Clin Oncol. 1985;3:1240–5. Muss H, Omura GA, Blessing JA, Major FJ, Lifshitz S, Mangan C, et al. A randomized clinical trial of adjuvant adriamycin in uterine sarcomas: a Gynecologic Oncology Group study. J Clin Oncol. 1985;3:1240–5.
26.
Zurück zum Zitat Buchsbaum HJ, Lifshitz S, Blythe JG. Prophylactic chemotherapy in stages I and II uterine sarcoma. Gynecol Oncol. 1979;8:346–8.PubMedCrossRef Buchsbaum HJ, Lifshitz S, Blythe JG. Prophylactic chemotherapy in stages I and II uterine sarcoma. Gynecol Oncol. 1979;8:346–8.PubMedCrossRef
27.
Zurück zum Zitat Hannigan EV, Freedman RS, Rutledge FN. Adjuvant chemotherapy in early uterine sarcoma. Gynecol Oncol. 1983;15:56–64.PubMedCrossRef Hannigan EV, Freedman RS, Rutledge FN. Adjuvant chemotherapy in early uterine sarcoma. Gynecol Oncol. 1983;15:56–64.PubMedCrossRef
28.
Zurück zum Zitat van Nagell JR, Hanson Jr MB, Donaldson ES, et al. Adjuvant vincristine, dactinomycin, and cyclophosphamide therapy in stage I uterine sarcomas. A pilot study. Cancer. 1986;57(8):1451–4.PubMedCrossRef van Nagell JR, Hanson Jr MB, Donaldson ES, et al. Adjuvant vincristine, dactinomycin, and cyclophosphamide therapy in stage I uterine sarcomas. A pilot study. Cancer. 1986;57(8):1451–4.PubMedCrossRef
29.
Zurück zum Zitat Piver MS, Lele SB, Marchetti DL, et al. Effect of adjuvant chemotherapy on time to recurrence and survival of stage I uterine sarcomas. J Surg Oncol. 1988;38(4):233–9.PubMedCrossRef Piver MS, Lele SB, Marchetti DL, et al. Effect of adjuvant chemotherapy on time to recurrence and survival of stage I uterine sarcomas. J Surg Oncol. 1988;38(4):233–9.PubMedCrossRef
30.
Zurück zum Zitat Hempling RE, Piver MS, Baker TR. Impact on progression-free survival of adjuvant cyclophosphamide, vincristine, doxorubicin (Adriamycin), and dacarbazine (CYVADIC) chemotherapy for stage I uterine sarcoma. Am J Clin Oncol. 1995;18:282–6.PubMedCrossRef Hempling RE, Piver MS, Baker TR. Impact on progression-free survival of adjuvant cyclophosphamide, vincristine, doxorubicin (Adriamycin), and dacarbazine (CYVADIC) chemotherapy for stage I uterine sarcoma. Am J Clin Oncol. 1995;18:282–6.PubMedCrossRef
31.
Zurück zum Zitat Gadducci A, Romanini A. Adjuvant chemotherapy in early stage uterine sarcomas: an open question. Eur J Gynaecol Oncol. 2001;22(5):352–7.PubMed Gadducci A, Romanini A. Adjuvant chemotherapy in early stage uterine sarcomas: an open question. Eur J Gynaecol Oncol. 2001;22(5):352–7.PubMed
32.
Zurück zum Zitat Odunsi K, Moneke V, Tammela J, et al. Efficacy of adjuvant CYVADIC chemotherapy in early stage uterine sarcomas: results of long-term follow-up. Int J Gynecol Cancer. 2004;14:659–64.PubMedCrossRef Odunsi K, Moneke V, Tammela J, et al. Efficacy of adjuvant CYVADIC chemotherapy in early stage uterine sarcomas: results of long-term follow-up. Int J Gynecol Cancer. 2004;14:659–64.PubMedCrossRef
33.
Zurück zum Zitat Wu TI, Chang TC, Hsueh S, et al. Prognostic factors and impact of adjuvant chemotherapy for uterine leiomyosarcoma. Gynecol Oncol. 2006;100:166–72.PubMedCrossRef Wu TI, Chang TC, Hsueh S, et al. Prognostic factors and impact of adjuvant chemotherapy for uterine leiomyosarcoma. Gynecol Oncol. 2006;100:166–72.PubMedCrossRef
34.
Zurück zum Zitat •• Gupta AA, Yao X, Verma S, Mackay H, Hopkins L. Sarcoma Disease Site Group, Gynecology Cancer Disease Site Group. Systematic chemotherapy for inoperable, locally advanced, recurrent, or metastatic uterine leiomyosarcoma: a systematic review. Clin Oncol. 2013;25:346–55. Recent meta-analysis on treatment of relapsed disease. •• Gupta AA, Yao X, Verma S, Mackay H, Hopkins L. Sarcoma Disease Site Group, Gynecology Cancer Disease Site Group. Systematic chemotherapy for inoperable, locally advanced, recurrent, or metastatic uterine leiomyosarcoma: a systematic review. Clin Oncol. 2013;25:346–55. Recent meta-analysis on treatment of relapsed disease.
35.
Zurück zum Zitat Martin-Liberal J, Benson C. Systemic chemotherapy for inoperable, locally advanced, recurrent or metastatic uterine leiomyosarcoma. Clin Oncol. 2013;25:343–5.CrossRef Martin-Liberal J, Benson C. Systemic chemotherapy for inoperable, locally advanced, recurrent or metastatic uterine leiomyosarcoma. Clin Oncol. 2013;25:343–5.CrossRef
36.
Zurück zum Zitat Hensley ML, Ishill N, Soslow R, et al. Adjuvant gemcitabine plus docetaxel for completely resected stages I-IV high grade uterine leiomyosarcoma. Results of a prospective study. Gynecol Oncol. 2009;112(3):563–7.PubMedCrossRef Hensley ML, Ishill N, Soslow R, et al. Adjuvant gemcitabine plus docetaxel for completely resected stages I-IV high grade uterine leiomyosarcoma. Results of a prospective study. Gynecol Oncol. 2009;112(3):563–7.PubMedCrossRef
37.
Zurück zum Zitat • Hensley ML, Wathen JK, Maki RG, Araujo DM, Sutton G, Priebat DA, et al. Adjuvant therapy for high-grade, uterus-limited leiomyosarcoma: results of a phase 2 trial (SARC 005). Cancer. 2013;119(8):1555–61. Recent approaches to improving care. • Hensley ML, Wathen JK, Maki RG, Araujo DM, Sutton G, Priebat DA, et al. Adjuvant therapy for high-grade, uterus-limited leiomyosarcoma: results of a phase 2 trial (SARC 005). Cancer. 2013;119(8):1555–61. Recent approaches to improving care.
38.
Zurück zum Zitat Pautier P, Floquet A, Gladieff L, Bompas E, Ray-Coquard I, Piperno-Neumann S, et al. A randomized clinical trial of adjuvant chemotherapy with doxorubicin, ifosfamide, and cisplatin followed by radiotherapy versus radiotherapy alone in patients with localized uterine sarcomas (SARCGYN study). A study of the French Sarcoma Group. Ann Oncol. 2013;24(4):1099–104.PubMedCrossRef Pautier P, Floquet A, Gladieff L, Bompas E, Ray-Coquard I, Piperno-Neumann S, et al. A randomized clinical trial of adjuvant chemotherapy with doxorubicin, ifosfamide, and cisplatin followed by radiotherapy versus radiotherapy alone in patients with localized uterine sarcomas (SARCGYN study). A study of the French Sarcoma Group. Ann Oncol. 2013;24(4):1099–104.PubMedCrossRef
39.
Zurück zum Zitat Edwards CL. Undifferentiated tumours. In: Cancer of the uterus and ovary. Chicago: Year Book; 1969. p. 84–94 Edwards CL. Undifferentiated tumours. In: Cancer of the uterus and ovary. Chicago: Year Book; 1969. p. 84–94
40.
Zurück zum Zitat Badib AO, Vongtama V, Kurohara SS, Webster JH. Radiotherapy in the treatment of sarcomas of the corpus uteri. Cancer. 1969;24:724–9.PubMedCrossRef Badib AO, Vongtama V, Kurohara SS, Webster JH. Radiotherapy in the treatment of sarcomas of the corpus uteri. Cancer. 1969;24:724–9.PubMedCrossRef
41.
Zurück zum Zitat Belgrad R, Elbadawi N, Rubin P. Uterine sarcoma. Radiology. 1975;144(1):181–8. Belgrad R, Elbadawi N, Rubin P. Uterine sarcoma. Radiology. 1975;144(1):181–8.
42.
Zurück zum Zitat Salazar O, Bonfiglio TK, Patten SF, Kellser BE, Feldstein ME, Dunne ME, et al. Uterine sarcomas: natural history, treatment and prognosis. Cancer. 1978;42:1152–60.PubMedCrossRef Salazar O, Bonfiglio TK, Patten SF, Kellser BE, Feldstein ME, Dunne ME, et al. Uterine sarcomas: natural history, treatment and prognosis. Cancer. 1978;42:1152–60.PubMedCrossRef
43.
Zurück zum Zitat Salazar OM, Bonfiglio TA, Patten SF, Keller BE, Feldstein ML, Dunne ME, et al. Uterine sarcomas. Analysis of failures with special emphasis on the use of adjuvant radiotherapy. Cancer. 1978;42:1161–70.PubMedCrossRef Salazar OM, Bonfiglio TA, Patten SF, Keller BE, Feldstein ML, Dunne ME, et al. Uterine sarcomas. Analysis of failures with special emphasis on the use of adjuvant radiotherapy. Cancer. 1978;42:1161–70.PubMedCrossRef
44.
Zurück zum Zitat Sorbe B. Radiotherapy and/or chemotherapy as adjuvant treatment of uterine sarcomas. Gynecol Oncol. 1985;20:281–9.PubMedCrossRef Sorbe B. Radiotherapy and/or chemotherapy as adjuvant treatment of uterine sarcomas. Gynecol Oncol. 1985;20:281–9.PubMedCrossRef
45.
Zurück zum Zitat Hornback NB, Omura G, Major FJ. Observations on the use of adjuvant radiation therapy in patients with stage I and II uterine sarcoma. Int J Radiat Oncol Biol Phys. 1986;12(12):2127–30.PubMedCrossRef Hornback NB, Omura G, Major FJ. Observations on the use of adjuvant radiation therapy in patients with stage I and II uterine sarcoma. Int J Radiat Oncol Biol Phys. 1986;12(12):2127–30.PubMedCrossRef
46.
Zurück zum Zitat Le T. Adjuvant pelvic radiotherapy for uterine carcinosarcoma in a high risk population. Eur J Surg Oncol. 2001;27(3):282–5.PubMedCrossRef Le T. Adjuvant pelvic radiotherapy for uterine carcinosarcoma in a high risk population. Eur J Surg Oncol. 2001;27(3):282–5.PubMedCrossRef
47.
Zurück zum Zitat Chi DS, Mychalczak B, Saigo PE, Rescigno J, Brown CL. The role of whole pelvic irradiation in the treatment of early-stage uterine carcinosarcoma. Gynecol Oncol. 1997;65:493–8.PubMedCrossRef Chi DS, Mychalczak B, Saigo PE, Rescigno J, Brown CL. The role of whole pelvic irradiation in the treatment of early-stage uterine carcinosarcoma. Gynecol Oncol. 1997;65:493–8.PubMedCrossRef
48.
Zurück zum Zitat Dusenbery KE, Potish RA, Agenta PA, et al. On the apparent failure of adjuvant pelvic radiotherapy to improve survival for women with uterine sarcomas confined to the uterus. Am J Clin Oncol. 2005;28:295–300.PubMedCrossRef Dusenbery KE, Potish RA, Agenta PA, et al. On the apparent failure of adjuvant pelvic radiotherapy to improve survival for women with uterine sarcomas confined to the uterus. Am J Clin Oncol. 2005;28:295–300.PubMedCrossRef
49.
Zurück zum Zitat Mahdavi A, Monk BJ, Ragazzo J, Hunter MI, Lentz SE, Vasilev SA, et al. Pelvic radiation improves local control after hysterectomy for uterine leiomyosarcoma: a 20-year experience. Int J Gynecol Cancer. 2009;19(6):1080–4.PubMedCrossRef Mahdavi A, Monk BJ, Ragazzo J, Hunter MI, Lentz SE, Vasilev SA, et al. Pelvic radiation improves local control after hysterectomy for uterine leiomyosarcoma: a 20-year experience. Int J Gynecol Cancer. 2009;19(6):1080–4.PubMedCrossRef
50.
Zurück zum Zitat Reed NS, Mangioni C, Malmstrom H, et al. First results of a randomised trial comparing radiotherapy versus- observation post operatively in patients with uterine sarcomas, an EORTC-GCG study. Eur J Cancer. 2008;44(6):808–18.PubMedCrossRef Reed NS, Mangioni C, Malmstrom H, et al. First results of a randomised trial comparing radiotherapy versus- observation post operatively in patients with uterine sarcomas, an EORTC-GCG study. Eur J Cancer. 2008;44(6):808–18.PubMedCrossRef
51.
Zurück zum Zitat Kanjeekal S, Chambers A, Kee Fung MF, Verma S. Systemic therapy for advanced uterine sarcoma: a systematic review of the literature. Gynecol Oncol. 2005;97:624–37.PubMedCrossRef Kanjeekal S, Chambers A, Kee Fung MF, Verma S. Systemic therapy for advanced uterine sarcoma: a systematic review of the literature. Gynecol Oncol. 2005;97:624–37.PubMedCrossRef
52.
Zurück zum Zitat Omura GA, Major FJ, Blessing JA, Sedlacek TV, Thigpen JT, Creasman WT, et al. A randomized study of Adriamycin with and without dimethyl triazenoimidazole carboxamide in advanced uterine sarcomas. Cancer. 1983;52:626–32.PubMedCrossRef Omura GA, Major FJ, Blessing JA, Sedlacek TV, Thigpen JT, Creasman WT, et al. A randomized study of Adriamycin with and without dimethyl triazenoimidazole carboxamide in advanced uterine sarcomas. Cancer. 1983;52:626–32.PubMedCrossRef
53.
Zurück zum Zitat Hannigan EV, Elder KW, Rutledge FN. Treatment of advanced uterine sarcoma with vincristine, actinomycin D and cyclophosphamide. Gynecol Oncol. 1983;15:224–9.PubMedCrossRef Hannigan EV, Elder KW, Rutledge FN. Treatment of advanced uterine sarcoma with vincristine, actinomycin D and cyclophosphamide. Gynecol Oncol. 1983;15:224–9.PubMedCrossRef
54.
Zurück zum Zitat Sutton GP, Blessing JA, Rosenshein N, Photopoulos G, DiSaia PJ. Phase II trial of ifosfamide and mesna in mixed mesodermal tumors of the uterus (a Gynecologic Oncology Group study). Am J Obstet Gynecol. 1989;161:309–15.PubMedCrossRef Sutton GP, Blessing JA, Rosenshein N, Photopoulos G, DiSaia PJ. Phase II trial of ifosfamide and mesna in mixed mesodermal tumors of the uterus (a Gynecologic Oncology Group study). Am J Obstet Gynecol. 1989;161:309–15.PubMedCrossRef
55.
Zurück zum Zitat Thigpen T, Blessing JA, Wilbanks GD. Cisplatin as second line therapy in the treatment of patients with advanced or recurrent leiomyosarcoma of the uterus. A phase II trial of the gynecologic oncology group. Am J Clin Oncol. 1986;9:18–20.PubMedCrossRef Thigpen T, Blessing JA, Wilbanks GD. Cisplatin as second line therapy in the treatment of patients with advanced or recurrent leiomyosarcoma of the uterus. A phase II trial of the gynecologic oncology group. Am J Clin Oncol. 1986;9:18–20.PubMedCrossRef
56.
Zurück zum Zitat Thigpen JT, Blessing JA, Beecham J, Homesley H, Yordan E. Phase II trial of cisplatin as first-line chemotherapy in patients with advanced or recurrent uterine sarcomas: a Gynecologic Oncology Group study. J Clin Oncol. 1991;9:1962–6.PubMed Thigpen JT, Blessing JA, Beecham J, Homesley H, Yordan E. Phase II trial of cisplatin as first-line chemotherapy in patients with advanced or recurrent uterine sarcomas: a Gynecologic Oncology Group study. J Clin Oncol. 1991;9:1962–6.PubMed
57.
Zurück zum Zitat Sutton GP, Blessing JA, Barrett RJ, McGehee R. Phase II trial of ifosfamide and mesna in leiomyosarcoma of the uterus: a Gynecologic Oncology Group study. Am J Obstet Gynecol. 1992;166:556–9.PubMedCrossRef Sutton GP, Blessing JA, Barrett RJ, McGehee R. Phase II trial of ifosfamide and mesna in leiomyosarcoma of the uterus: a Gynecologic Oncology Group study. Am J Obstet Gynecol. 1992;166:556–9.PubMedCrossRef
58.
Zurück zum Zitat Sutton GP, Blessing JA, Malfetano JH. Ifosfamide and doxorubicin in the treatment of advanced leiomyosarcomas of the uterus: a Gynecologic Oncology Group study. Gynecol Oncol. 1996;62:226–9.PubMedCrossRef Sutton GP, Blessing JA, Malfetano JH. Ifosfamide and doxorubicin in the treatment of advanced leiomyosarcomas of the uterus: a Gynecologic Oncology Group study. Gynecol Oncol. 1996;62:226–9.PubMedCrossRef
59.
Zurück zum Zitat Leyvraz S, Bacchi M, Lissoni A, Sessa C, Cerny T, Honegger HP. High response rate with the combination of high-dose ifosfamide and doxorubicin for the treatment of advanced gynecologic sarcomas. Proc Am Soc Clin Oncol. 1998;17:354a. Leyvraz S, Bacchi M, Lissoni A, Sessa C, Cerny T, Honegger HP. High response rate with the combination of high-dose ifosfamide and doxorubicin for the treatment of advanced gynecologic sarcomas. Proc Am Soc Clin Oncol. 1998;17:354a.
60.
Zurück zum Zitat Sutton G, Blessing JA, Ball H. Phase II trial of paclitaxel in leiomyosarcoma of the uterus: a Gynecologic Oncology Group study. Gynecol Oncol. 1999;74:346–9.PubMedCrossRef Sutton G, Blessing JA, Ball H. Phase II trial of paclitaxel in leiomyosarcoma of the uterus: a Gynecologic Oncology Group study. Gynecol Oncol. 1999;74:346–9.PubMedCrossRef
61.
Zurück zum Zitat Miller DS, Blessing JA, Kilgore LC, Mannel R, Van Le L. Phase II trial of topotecan in patients with advanced, persistent or recurrent uterine leiomyosarcomas: a Gynecologic Oncology Group study. Am J Clin Oncol. 2000;23:355–7.PubMedCrossRef Miller DS, Blessing JA, Kilgore LC, Mannel R, Van Le L. Phase II trial of topotecan in patients with advanced, persistent or recurrent uterine leiomyosarcomas: a Gynecologic Oncology Group study. Am J Clin Oncol. 2000;23:355–7.PubMedCrossRef
62.
Zurück zum Zitat Hensley ML, Maki R, Venkatraman E, Geller G, Lovegren M, Aghajanian C, et al. Gemcitabine and docetaxel in patients with unresectable leiomyosarcoma: results of a phase II trial. J Clin Oncol. 2002;12:2824–31.CrossRef Hensley ML, Maki R, Venkatraman E, Geller G, Lovegren M, Aghajanian C, et al. Gemcitabine and docetaxel in patients with unresectable leiomyosarcoma: results of a phase II trial. J Clin Oncol. 2002;12:2824–31.CrossRef
63.
Zurück zum Zitat Gallup DG, Blessing JA, Andersen W, Morgan MA. Evaluation of paclitaxel in previously treated leiomyosarcoma of the uterus: a gynecologic oncology group study. Gynecol Oncol. 2003;89:48–51.PubMedCrossRef Gallup DG, Blessing JA, Andersen W, Morgan MA. Evaluation of paclitaxel in previously treated leiomyosarcoma of the uterus: a gynecologic oncology group study. Gynecol Oncol. 2003;89:48–51.PubMedCrossRef
64.
Zurück zum Zitat Lorigan P, Verweij J, Papai Z, et al. Phase III trial of two investigational schedules of ifosfamide compared with standard-dose doxorubicin in advanced or metastatic soft tissue sarcoma: a European Organisation for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group Study. J Clin Oncol. 2007;25(21):3144–50.PubMedCrossRef Lorigan P, Verweij J, Papai Z, et al. Phase III trial of two investigational schedules of ifosfamide compared with standard-dose doxorubicin in advanced or metastatic soft tissue sarcoma: a European Organisation for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group Study. J Clin Oncol. 2007;25(21):3144–50.PubMedCrossRef
65.
Zurück zum Zitat Look KY, Sandler A, Blessing JA, Lucci III JA, Rose PG. Phase II trial of gemcitabine as second-line chemotherapy of uterine leiomyosarcoma: a gynecologic oncology group (GOG) study. Gynecol Oncol. 2004;92:644–7.PubMedCrossRef Look KY, Sandler A, Blessing JA, Lucci III JA, Rose PG. Phase II trial of gemcitabine as second-line chemotherapy of uterine leiomyosarcoma: a gynecologic oncology group (GOG) study. Gynecol Oncol. 2004;92:644–7.PubMedCrossRef
66.
Zurück zum Zitat Leyvraz S, Zweifel M, Jundt G, Lissoni A, Cerny T, Sessa C, et al. Long-term results of a multicenter SAKK trial on highdose ifosfamide and doxorubicin in advanced or metastatic gynecologic sarcomas. Ann Oncol. 2006;17:646–51.PubMedCrossRef Leyvraz S, Zweifel M, Jundt G, Lissoni A, Cerny T, Sessa C, et al. Long-term results of a multicenter SAKK trial on highdose ifosfamide and doxorubicin in advanced or metastatic gynecologic sarcomas. Ann Oncol. 2006;17:646–51.PubMedCrossRef
67.
Zurück zum Zitat Edmonson JH, Blessing JA, Cosin JA, Miller DS, Cohn DE, Rotmensch J. Phase II study of mitomycin, doxorubicin, and cisplatin in the treatment of advanced uterine leiomyosarcoma: a Gynecologic Oncology Group study. Gynecol Oncol. 2002;507–10. Edmonson JH, Blessing JA, Cosin JA, Miller DS, Cohn DE, Rotmensch J. Phase II study of mitomycin, doxorubicin, and cisplatin in the treatment of advanced uterine leiomyosarcoma: a Gynecologic Oncology Group study. Gynecol Oncol. 2002;507–10.
68.
Zurück zum Zitat Hensley ML, Blessing J, Mannel R, Rose PG. Fixed-dose rate gemcitabine plus docetaxel as first-line therapy for metastatic uterine leiomyosarcoma: a Gynecologic Oncology Group phase II trial. Gynecol Oncol. 2008;109:329–34.PubMedCrossRef Hensley ML, Blessing J, Mannel R, Rose PG. Fixed-dose rate gemcitabine plus docetaxel as first-line therapy for metastatic uterine leiomyosarcoma: a Gynecologic Oncology Group phase II trial. Gynecol Oncol. 2008;109:329–34.PubMedCrossRef
69.
Zurück zum Zitat Schoffski P, Wolter P, Clement P, Sciot R, De Wever I, Wozniak A, et al. Trabectedin (ET-743): evaluation of its use in advanced soft-tissue sarcoma. Future Oncol. 2007;3(4):381–92.PubMedCrossRef Schoffski P, Wolter P, Clement P, Sciot R, De Wever I, Wozniak A, et al. Trabectedin (ET-743): evaluation of its use in advanced soft-tissue sarcoma. Future Oncol. 2007;3(4):381–92.PubMedCrossRef
70.
Zurück zum Zitat Amant F, Coosemans A, Renard V, Everaert E, Vergote I. Clinical outcome of ET-743 (trabectedin; Yondelis) in high-grade uterine sarcomas: report on five patients and a review of the literature. Int J Gynecol Cancer. 2009;19(2):245–8.PubMedCrossRef Amant F, Coosemans A, Renard V, Everaert E, Vergote I. Clinical outcome of ET-743 (trabectedin; Yondelis) in high-grade uterine sarcomas: report on five patients and a review of the literature. Int J Gynecol Cancer. 2009;19(2):245–8.PubMedCrossRef
71.
Zurück zum Zitat Sanfilippo R, Grosso F, Jones RL, et al. Trabectedin in advanced uterine leiomyosarcomas: a retrospective case series analysis from two reference centers. Gynecol Oncol. 2011;123(3):553–6.PubMedCrossRef Sanfilippo R, Grosso F, Jones RL, et al. Trabectedin in advanced uterine leiomyosarcomas: a retrospective case series analysis from two reference centers. Gynecol Oncol. 2011;123(3):553–6.PubMedCrossRef
72.
Zurück zum Zitat Ray-Coquard I. An increasing role for trabectedin in gynecological cancers: efficacy in uterine sarcomas. Int J Gynecol Cancer. 2011;21 Suppl 1:S3–5.PubMedCrossRef Ray-Coquard I. An increasing role for trabectedin in gynecological cancers: efficacy in uterine sarcomas. Int J Gynecol Cancer. 2011;21 Suppl 1:S3–5.PubMedCrossRef
73.
Zurück zum Zitat Monk BJ, Blessing JA, Street DG, Muller CY, Burke JJ, Hensley ML. A phase II evaluation of trabectedin in the treatment of advanced, persistent, or recurrent uterine leiomyosarcoma: a Gynecologic Oncology Group study. Gynecol Oncol. 2012;124(1):48–52.PubMedCrossRef Monk BJ, Blessing JA, Street DG, Muller CY, Burke JJ, Hensley ML. A phase II evaluation of trabectedin in the treatment of advanced, persistent, or recurrent uterine leiomyosarcoma: a Gynecologic Oncology Group study. Gynecol Oncol. 2012;124(1):48–52.PubMedCrossRef
74.
Zurück zum Zitat Garber K. IGF-1: old growth factor shines as new drug target. J Natl Cancer Inst. 2005;97(11):790–2.PubMedCrossRef Garber K. IGF-1: old growth factor shines as new drug target. J Natl Cancer Inst. 2005;97(11):790–2.PubMedCrossRef
75.
Zurück zum Zitat Vu TH, Yballe C, Boonyanit S, Hoffman AR. Insulin-like growth factor II in uterine smooth-muscle tumors: maintenance of genomic imprinting in leiomyomata and loss of imprinting in leiomyosarcomata. J Clin Endocrinol Metab. 1995;80(5):1670–6.PubMedCrossRef Vu TH, Yballe C, Boonyanit S, Hoffman AR. Insulin-like growth factor II in uterine smooth-muscle tumors: maintenance of genomic imprinting in leiomyomata and loss of imprinting in leiomyosarcomata. J Clin Endocrinol Metab. 1995;80(5):1670–6.PubMedCrossRef
76.
Zurück zum Zitat Rikhof B, de Jong S, Suurmeijer AJ, Meijer C, van der Graaf WT. The insulin-like growth factor system and sarcomas. J Pathol. 2009;217(4):469–82.PubMedCrossRef Rikhof B, de Jong S, Suurmeijer AJ, Meijer C, van der Graaf WT. The insulin-like growth factor system and sarcomas. J Pathol. 2009;217(4):469–82.PubMedCrossRef
77.
Zurück zum Zitat King ER, Wong KK. Insulin-like growth factor: current concepts and new developments in cancer therapy. Recent Pat Anticancer Drug Discov. 2012;7(1):14–30.PubMedCrossRef King ER, Wong KK. Insulin-like growth factor: current concepts and new developments in cancer therapy. Recent Pat Anticancer Drug Discov. 2012;7(1):14–30.PubMedCrossRef
78.
Zurück zum Zitat Hernando H, Charytonowicz E, Dudas ME, Menendez S, et al. The AKT-mTOR pathway plays a critical role in the development of leiomyosarcomas. Nat Med. 2007;13:748–53.PubMedCrossRef Hernando H, Charytonowicz E, Dudas ME, Menendez S, et al. The AKT-mTOR pathway plays a critical role in the development of leiomyosarcomas. Nat Med. 2007;13:748–53.PubMedCrossRef
79.
Zurück zum Zitat van der Graaf WT, Blay JY, Chawla SP, et al. Pazopanib for metastatic soft-tissue sarcoma (PALETTE): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet. 2012;379(9829):1879–86.PubMedCrossRef van der Graaf WT, Blay JY, Chawla SP, et al. Pazopanib for metastatic soft-tissue sarcoma (PALETTE): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet. 2012;379(9829):1879–86.PubMedCrossRef
80.
Zurück zum Zitat O’Cearbhaill R, Zhou Q, Iasonos A, Soslow RA, Leitao MM, Aghajanian C, et al. Treatment of advanced uterine leiomyosarcoma with aromatase inhibitors. Gynecol Oncol. 2010;116:424–9.PubMedCrossRef O’Cearbhaill R, Zhou Q, Iasonos A, Soslow RA, Leitao MM, Aghajanian C, et al. Treatment of advanced uterine leiomyosarcoma with aromatase inhibitors. Gynecol Oncol. 2010;116:424–9.PubMedCrossRef
81.
Zurück zum Zitat Levenback C, Rubin SC, McCormack PM, et al. Resection of pulmonary metastases from uterine sarcomas. Gynecol Oncol. 1992;45:202–5.PubMedCrossRef Levenback C, Rubin SC, McCormack PM, et al. Resection of pulmonary metastases from uterine sarcomas. Gynecol Oncol. 1992;45:202–5.PubMedCrossRef
82.
Zurück zum Zitat Leitao MM, Brennan MF, Hensley M, et al. Surgical resection of pulmonary and extrapulmonary recurrences of uterine leiomyosarcoma. Gynecol Oncol. 2002;87:287–94.PubMedCrossRef Leitao MM, Brennan MF, Hensley M, et al. Surgical resection of pulmonary and extrapulmonary recurrences of uterine leiomyosarcoma. Gynecol Oncol. 2002;87:287–94.PubMedCrossRef
83.
Zurück zum Zitat Mountain CF, McMurtrey MJ, Hermes KE. Surgery for pulmonary metastasis: a 20-year experience. Ann Thorac Surg. 1984;38:323–30.PubMedCrossRef Mountain CF, McMurtrey MJ, Hermes KE. Surgery for pulmonary metastasis: a 20-year experience. Ann Thorac Surg. 1984;38:323–30.PubMedCrossRef
84.
Zurück zum Zitat Gillams AR, Lees WR. Radiofrequency ablation of lung metastases: factors influencing success. Eur Radiol. 2008;18(4):672–7.PubMedCrossRef Gillams AR, Lees WR. Radiofrequency ablation of lung metastases: factors influencing success. Eur Radiol. 2008;18(4):672–7.PubMedCrossRef
85.
Zurück zum Zitat Giuntoli II RL, Garrett-Mayer E, Bristow RE, Gostout BS. Secondary cytoreduction in the management of recurrent uterine leiomyosarcoma. Gynecol Oncol. 2007;106(1):82.PubMedCrossRef Giuntoli II RL, Garrett-Mayer E, Bristow RE, Gostout BS. Secondary cytoreduction in the management of recurrent uterine leiomyosarcoma. Gynecol Oncol. 2007;106(1):82.PubMedCrossRef
86.
Zurück zum Zitat • Zivanovic O, Jacks LM, Iasonos A, Leitao Jr MM, Soslow RA, Veras E, et al. A nomogram to predict postresection 5-year overall survival for patients with uterine leiomyosarcoma. Cancer. 2012;118(3):660–9. doi:10.1002/cncr.26333. Use of a predictive nomogram to improve care. • Zivanovic O, Jacks LM, Iasonos A, Leitao Jr MM, Soslow RA, Veras E, et al. A nomogram to predict postresection 5-year overall survival for patients with uterine leiomyosarcoma. Cancer. 2012;118(3):660–9. doi:10.​1002/​cncr.​26333. Use of a predictive nomogram to improve care.
Metadaten
Titel
A Review of Treatment of Uterine Leiomyosarcomas
verfasst von
Nicholas Reed
Publikationsdatum
01.12.2013
Verlag
Springer US
Erschienen in
Current Oncology Reports / Ausgabe 6/2013
Print ISSN: 1523-3790
Elektronische ISSN: 1534-6269
DOI
https://doi.org/10.1007/s11912-013-0350-4

Weitere Artikel der Ausgabe 6/2013

Current Oncology Reports 6/2013 Zur Ausgabe

Cancer Prevention (J Cuzick, Section Editor)

Role of Aspirin in Cancer Prevention

Adjuvante Immuntherapie verlängert Leben bei RCC

25.04.2024 Nierenkarzinom Nachrichten

Nun gibt es auch Resultate zum Gesamtüberleben: Eine adjuvante Pembrolizumab-Therapie konnte in einer Phase-3-Studie das Leben von Menschen mit Nierenzellkarzinom deutlich verlängern. Die Sterberate war im Vergleich zu Placebo um 38% geringer.

Alectinib verbessert krankheitsfreies Überleben bei ALK-positivem NSCLC

25.04.2024 NSCLC Nachrichten

Das Risiko für Rezidiv oder Tod von Patienten und Patientinnen mit reseziertem ALK-positivem NSCLC ist unter einer adjuvanten Therapie mit dem Tyrosinkinase-Inhibitor Alectinib signifikant geringer als unter platinbasierter Chemotherapie.

Bei Senioren mit Prostatakarzinom auf Anämie achten!

24.04.2024 DGIM 2024 Nachrichten

Patienten, die zur Behandlung ihres Prostatakarzinoms eine Androgendeprivationstherapie erhalten, entwickeln nicht selten eine Anämie. Wer ältere Patienten internistisch mitbetreut, sollte auf diese Nebenwirkung achten.

ICI-Therapie in der Schwangerschaft wird gut toleriert

Müssen sich Schwangere einer Krebstherapie unterziehen, rufen Immuncheckpointinhibitoren offenbar nicht mehr unerwünschte Wirkungen hervor als andere Mittel gegen Krebs.

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.