Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Songpa-Gu, Seoul, Republic of Korea.
Curr Opin Obstet Gynecol. 2010 Feb;22(1):36-42. doi: 10.1097/GCO.0b013e328334d90f.
Uterine sarcoma is a rare but extremely aggressive subtype of uterine malignancy. This heterogeneous group of tumors consists of several histologic types, including carcinosarcoma, leiomyosarcoma, and endometrial stromal sarcoma. Because of tumor rarity and histopathologic diversity, no standardized treatment for any histologic type has yet been established. In this review, we discuss recent studies and update the management of uterine sarcomas.
The recent trend is to treat each histologic type separately. New International Federation of Obstetrics and Gynecology staging systems unique to each histologic type have been developed. Prospective and retrospective studies have focused primarily on adjuvant therapy after surgical resection.
Surgery remains the mainstay of treatment for uterine sarcoma, demonstrating a curative potential regardless of histologic type. Effective adjuvant therapy to prolong survival has not yet been established. Because neither currently available radiation therapy nor different combinations of cytotoxic chemotherapeutic agents is likely to have a major impact on the course of uterine sarcoma, alternative approaches such as molecularly targeted therapies need to be explored.
子宫肉瘤是一种罕见但极具侵袭性的子宫恶性肿瘤亚型。这组异质性肿瘤包括癌肉瘤、平滑肌肉瘤和子宫内膜间质肉瘤等几种组织学类型。由于肿瘤罕见且组织病理学多样，尚未为任何组织学类型制定标准化的治疗方案。在这篇综述中，我们讨论了最近的研究进展，并更新了子宫肉瘤的治疗方法。
最近的趋势是分别治疗每种组织学类型。针对每种组织学类型，已开发出独特的新国际妇产科联合会分期系统。前瞻性和回顾性研究主要集中在手术切除后的辅助治疗上。
手术仍然是子宫肉瘤治疗的主要手段，无论组织学类型如何，都具有治愈的潜力。尚未确定有效的辅助治疗方法来延长生存时间。由于目前可用的放疗或不同组合的细胞毒性化疗药物不太可能对子宫肉瘤的病程产生重大影响，因此需要探索其他方法，如分子靶向治疗。
