The role of lymphadenectomy in uterine leiomyosarcoma: review of the literature and recommendations for the standard surgical procedure.
Uterine sarcomas are rare and aggressive gynaecologic malignancies with poor prognosis, arising from myometrial or endometrial tissue. These rare cancers can be aggressive, and account for a greatly disproportionate amount of deaths from uterine cancers. The histological uterine sarcomas classification includes carcinosarcomas (malignant mesodermal mixed tumors), accounting for 40% of cases, leiomyosarcomas (40%) and endometrial stromal sarcomas (10-15%). Each group of these tumors presents differences in diagnosis, prognostic factors, treatment, and outcome. Uterine leiomyosarcomas typically affects women in their sixth decade of life, presenting with atypical symptoms such as abnormal uterine bleeding and abdominal pain. The optimal treatment of uterine leiomyosarcomas is surgery, including total abdominal hysterectomy and bilateral salpingooophorectomy. The aim of this study was to conduct a systematic review of the literature regarding the standard surgical procedure of uterine leiomyosarcomas and investigate whether lymphadenectomy affects the 5-year DSS, as well as other relevant clinical outcomes, in women with uterine leiomyosarcomas. For this purpose, MEDLINE, EMBASE, and the Cochrane Library databases were reviewed, and a critical account of the management strategies of these tumors is presented.
Dafopoulos
Alexandros
A
Department of Obstetrics and Gynecology, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece.
Tsikouras
Panagiotis
P
Dimitraki
Marina
M
Galazios
Georgios
G
Liberis
Vasileios
V
Maroulis
Georgios
G
Teichmann
Alexander Tobias
AT
D002296:Carcinosarcoma / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007890:Leiomyosarcoma / Q000473:pathology / Q000601:surgery*; D008197:Lymph Node Excision; D009367:Neoplasm Staging; D016019:Survival Analysis; D014594:Uterine Neoplasms / Q000473:pathology / Q000601:surgery*