Surgical Oncology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
OncoSARC (Oncogenesis of Sarcoma), INSERM UMR1037, Toulouse, France.
Int J Gynecol Cancer. 2024 Mar 4;34(3):393-402. doi: 10.1136/ijgc-2023-004582.
Adult-type gynecological soft tissue and visceral sarcomas are rare tumors, with an estimated incidence of 13% of all sarcomas and 4% of all gynecological malignancies. They most often develop in the uterus (83%), followed by the ovaries (8%), vulva and vagina (5%), and other gynecological organs (2%). The objective of this review is to provide an overview of the current management of gynecological sarcomas, according to international guidelines. The management of gynecological sarcomas should follow the recommendations for the management of soft tissue and visceral sarcomas. Centralizing cases in expert centers improves patient survival, both for the diagnostic phase and for multidisciplinary therapeutic management. In the case of pelvic soft tissue sarcomas, a radiological biopsy is essential before any surgical decision is taken. In the case of a myometrial tumour which may correspond to a sarcoma, if conservative surgery such as myomectomy or morcellation is planned, an ultrasound-guided biopsy with pathological analysis including comparative genomic hybridization analysis must be carried out. In all cases, en bloc surgery, without rupture, is mandatory. Many rare histological subtypes require specific surgical management.
成人型妇科软组织和内脏肉瘤是罕见的肿瘤，估计占所有肉瘤的 13%，占所有妇科恶性肿瘤的 4%。它们最常发生在子宫（83%），其次是卵巢（8%）、外阴和阴道（5%），以及其他妇科器官（2%）。本综述的目的是根据国际指南，概述妇科肉瘤的当前治疗方法。妇科肉瘤的治疗应遵循软组织和内脏肉瘤治疗的建议。将病例集中在专家中心可提高患者的生存率，无论是在诊断阶段还是在多学科治疗管理中。对于盆腔软组织肉瘤，在做出任何手术决定之前，都需要进行影像学活检。对于可能是肉瘤的子宫肿瘤，如果计划进行保守手术，如子宫肌瘤切除术或碎切术，则必须进行超声引导活检，并进行包括比较基因组杂交分析的病理分析。在所有情况下，都必须进行整块手术，避免破裂。许多罕见的组织学亚型需要特定的手术管理。
