Köhler G
Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum der Ernst-Moritz-Arndt-Universität Greifswald, Greifswald, Deutschland.
Pathologe. 2009 Jul;30(4):304-12. doi: 10.1007/s00292-009-1150-3.
There are many common features between uterine sarcomas - leiomyosarcoma, endometrial stromal sarcoma, undifferentiated endometrial sarcoma and adenosarcoma -with regards to course, therapy and follow-up, such as post-menopausal bleeding or additional premenopausal bleeding, as well as rapid growth. There is a new staging system according to FIGO and new therapy recommendations according to NCCN. Prior to therapy, imaging staging of the pelvis, abdomen and chest should be carried out due to the frequency with which metastases are found at the time of diagnosis. In the case of disease spread in uterine sarcomas and malignant mixed tumors, good supportive therapy is a possible therapy option instead of chemo- or radiotherapy. The approach - observation, surgery, lymphonodectomy, mono- or polychemotherapy, radiotherapy, hormone therapy - is chosen according to the extent of spread and the resection status. Neoadjuvant therapies are not as yet established.
子宫肉瘤(平滑肌肉瘤、子宫内膜间质肉瘤、未分化子宫内膜肉瘤和腺肉瘤)在病程、治疗及随访方面有许多共同特征,比如绝经后出血或绝经前额外出血,以及生长迅速。有根据国际妇产科联盟(FIGO)制定的新分期系统和根据美国国立综合癌症网络(NCCN)制定的新治疗建议。治疗前,鉴于诊断时发现转移的频率,应进行盆腔、腹部和胸部的影像学分期。对于子宫肉瘤和恶性混合瘤出现疾病播散的情况,良好的支持治疗是一种可行的治疗选择,而非化疗或放疗。治疗方法(观察、手术、淋巴结切除术、单药或多药化疗、放疗、激素治疗)根据播散范围和切除情况来选择。新辅助治疗尚未确立。