Department of Medical Oncology, Centre Léon Bérard, Lyon Cedex.
University Claude Bernard Lyon I, Lyon, France.
Curr Opin Oncol. 2018 Jul;30(4):246-251. doi: 10.1097/CCO.0000000000000462.
In this article, we focus on recent published data (2017) on the management of gynecologic sarcomas.
The most significant data published in 2017 develop definition of a new molecular subtype of high grade endometrial stromal sarcoma (ESS) using molecular technics added to histological analysis. The identification of a new translocation on presumed uterine leiomyosarcoma (LMS) points to refinement of nosological classification, with fragmentation of even rare tumors into distinct molecular entities: gynecologic sarcomas are now distinguished into distinct entities from a heterogeneous group of tumors. Other articles have discussed the real incidence of unsuspected sarcomas after fibroid mini-invasive surgery and evaluate the risk of relapse and dissemination after morcellation. Among several criteria, preoperative imagery could become a useful tool. For systemic treatment, no clinical trials changing practices were published, only one positive nonrandomized phase II with carboplatin and pegylated liposomal doxorubicin (PLD) in the treatment of uterine sarcomas after the conventional first line, especially in LMSs and ESSs.
Many articles were published on this confidential domain in oncology demonstrating interests on rare sarcomas. All specialties were represented in the literature, even though we are still waiting for urgent improvements in early diagnosis and therapeutic strategies to transform the poor prognostic of these tumors.
本文重点介绍了 2017 年发表的妇科肉瘤治疗的最新数据。
2017 年发表的最重要数据是使用组织学分析之外的分子技术对高级子宫内膜间质肉瘤(ESS)进行新的分子亚型定义。在假定的子宫平滑肌肉瘤(LMS)中发现的新易位指向分类学的细化,即使是罕见的肿瘤也被细分到不同的分子实体中:妇科肉瘤现在与一组异质性肿瘤区分开来。其他文章讨论了在子宫肌瘤微创手术后未被怀疑的肉瘤的实际发生率,并评估了在分碎后复发和扩散的风险。在几个标准中,术前影像学可能成为一个有用的工具。在系统治疗方面,没有发表改变实践的临床试验,只有一项在传统一线治疗后的子宫肉瘤(尤其是在 LMS 和 ESS 中)中使用卡铂和聚乙二醇化脂质体多柔比星(PLD)的阳性非随机 II 期临床试验。
在肿瘤学领域发表了许多关于这些罕见肉瘤的文章,表明了人们对其的关注。尽管我们仍在等待早期诊断和治疗策略的紧急改进,以改变这些肿瘤的不良预后,但所有专业都在文献中得到了体现。