Gynecologic Cancers

Sarcoma

Questions discussed in this category

When the initial diagnosis of stage I uterine leiomyosarcoma is made via a non-intact resection such as a myomectomy or supracervical hysterectomy, what factors, if any, might push you to consider adjuvant chemotherapy after completion surgery?

1 Answer available

How would you approach the adjuvant treatment of a stage IVA adenosarcoma of the ovary?

Would your systemic therapy choice be more similar to treatment of ovarian carcinoma or soft tissue sarcoma?

1 Answer available

What is your treatment approach for a pediatric patient with uterine embryonal rhabdomyosarcoma found after removal of a prolapsing uterine mass, with no evidence of distant metastasis on imaging?

1 Answer available

Would you consider definitive radiation therapy (EBRT + interstitial HDR) in lieu of pelvic exenteration for a vaginal spindle cell sarcoma?

1 Answer available

Do you routinely perform bilateral oophorectomy at the time of hysterectomy for a premenopausal woman with a uterine leiomyosarcoma that appears to be limited to the uterus?

Does ER/PR status help guide your decision?

1 Answer available

Would you give adjuvant therapy after diagnosis of presumed stage IA, 5cm, ER/PR+ uterine adenosarcoma on a total hysterectomy with bilateral salpingoopheretomy without staging?

No sarcomatous overgrowth seen.

1 Answer available

What is your approach to adjuvant therapy for a fully resected (contained morcellation and laparoscopic removal), isolated retroperitoneal leiomyosarcoma in a patient with a remote history of a hysterectomy?

1 Answer available

How would you manage a recurrent uterine leiomyosarcoma, now status post secondary cytoreduction, with no gross residual disease?

Would you consider adjuvant chemotherapy, radiation therapy, hormone therapy, or surveillance?

1 Answer available

Would you offer adjuvant radiation to a patient with a vaginal spindle cell sarcoma s/p modified radical hysterectomy with bilateral sapingoopherectomy with negative margins?

Final pathology showed grade 3 spindle cell sarcoma of thee vagina involving the anterior lateral cervix 5.6cm x 4.5 x 3.4cm, <0.1cm left lateral m...

1 Answer available

What is your treatment approach to a young woman with widely metastatic low grade endometrial stromal sarcoma not amenable to complete cytoreduction?

Would you consider "neoadjuvant" hormonal therapy to shrink tumors and potentially make more amenable to complete cytoreduction at a later date? Woul...

1 Answer available

Would you offer adjuvant therapy following successful resection of a solitary lung recurrence of leiomyosarcoma if no other evidence of recurrent disease on PET CT?

1 Answer available

Would you offer adjuvant progesterone therapy to a young woman with low grade endometrial stromal sarcoma who had elected ovarian conservation?

1 Answer available

What adjuvant treatment would you offer a young woman with stage IB uterine mullerian adenosarcoma with sarcomatous overgrowth?

1 Answer available

What intracavitary brachytherapy regimen would you use after EBRT for a 4cm vaginal leiomyosarcoma the mid vagina with positive margins?

MRI with intravaginal gel shows no gross residual disease.

2 Answers available

Would you offer adjuvant radiation to a patient with uterine undifferentiated sarcoma s/p resection, vaginal cuff recurrence, and re-resection?

If so, would you treat the whole pelvis, cuff brachytherapy, or both?

2 Answers available

How do you approach adjuvant treatment of non-uterine leiomyosarcoma?

When, if ever, do you utilize adjuvant RT or chemotherapy?

2 Answers available

Is there a benefit to EBRT for recurrent solitary fibrous tumor/ hemangiopericytoma in patient with multiple sites of intrapelvic recurrence?

In a patient, with multiple small volume lesions (5-25mm), would you offer pelvic RT?

1 Answer available

Do you recommend stopping olaratumab in patients receiving doxorubicin/olaratumab for treatment of advanced sarcoma?

Given the recent press release regarding the update on the phase 3 soft tissue sarcoma study of LARTRUVO (olaratumab) showing no benefit to the combin...

1 Answer available

Papers discussed in this category

Int J Clin Exp Med, 2015 Sep 15

Postoperative recurrence solitary fibrous tumor of the pelvic with malignant transformation.

Pathol. Int.,

Advanced malignant solitary fibrous tumor in pelvis responding to radiation therapy.

Oncotarget,

The demographic features, clinicopathologic characteristics, treatment outcome and disease-specific prognostic factors of solitary fibrous tumor: a population-based analysis.

Ann Surg Oncol, 2014 Aug

Efficacy of adjuvant radiation therapy in the treatment of soft tissue sarcoma of the extremity: 20-year follow-up of a randomized prospective trial.

Cancer,

A systematic meta-analysis of randomized controlled trials of adjuvant chemotherapy for localized resectable soft-tissue sarcoma.

American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting, 2018-05-23

Neoadjuvant Chemotherapy, Concurrent Chemoradiation, and Adjuvant Chemotherapy for High-Risk Extremity Soft Tissue Sarcoma.

Acta Oncol, 2017 Apr 21

Predictive and prognostic factors associated with soft tissue sarcoma response to chemotherapy: a subgroup analysis of the European Organisation for Research and Treatment of Cancer 62012 study.

Lancet Oncol., 2017 Sep 04

Gemcitabine and docetaxel versus doxorubicin as first-line treatment in previously untreated advanced unresectable or metastatic soft-tissue sarcomas (GeDDiS): a randomised controlled phase 3 trial.

Lancet Oncol., 2012 Sep 04

Adjuvant chemotherapy with doxorubicin, ifosfamide, and lenograstim for resected soft-tissue sarcoma (EORTC 62931): a multicentre randomised controlled trial.

Gynecologic oncology, 2003-07

Low-grade endometrial stromal sarcoma: hormonal aspects.

Obstetrics and gynecology, 2013-09

Endometrial stromal sarcoma: a systematic review.

Lancet Oncol.,

Clinical management of uterine sarcomas.

Gynecol. Oncol., 2005 Dec 20

Harm or benefit of hormonal treatment in metastatic low-grade endometrial stromal sarcoma: single center experience with 10 cases and review of the literature.

Int J Gynecol Cancer,

Long-Term Outcome of Aromatase Inhibitor Therapy With Letrozole in Patients With Advanced Low-Grade Endometrial Stromal Sarcoma.

Gynecologic oncology, 2001-10

Uterine adenosarcoma with sarcomatous overgrowth versus uterine carcinosarcoma: comparison of treatment and survival.

Int. J. Gynecol. Pathol.,

Adenosarcoma of the uterus: a Gynecologic Oncology Group clinicopathologic study of 31 cases.

Eur. J. Cancer, 2008 Apr 02

Phase III randomised study to evaluate the role of adjuvant pelvic radiotherapy in the treatment of uterine sarcomas stages I and II: an European Organisation for Research and Treatment of Cancer Gynaecological Cancer Group Study (protocol 55874).

J Clin Oncol,

A randomized clinical trial of adjuvant adriamycin in uterine sarcomas: a Gynecologic Oncology Group Study.

Pediatric blood & cancer, 2018-02

Consensus and controversies regarding the treatment of rhabdomyosarcoma.

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