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Debate 40B - Should Primary Debulking Surgery be Performed for Metastatic Leiomyosarcoma?

No

from Section IV - Endometrial Cancer

Published online by Cambridge University Press:  20 July 2023

Dennis S. Chi
Affiliation:
Memorial Sloan-Kettering Cancer Center, New York
Nisha Lakhi
Affiliation:
Richmond University Medical Center, Staten Island
Nicoletta Colombo
Affiliation:
University of Milan-Bicocca
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Summary

Uterine leiomyosarcoma (uLMS) is a relatively rare uterine cancer that behaves aggressively, with high lethality, even in the setting of early-stage disease at diagnosis. Given the propensity for metastases even in apparent early-stage disease, and relative resistance to chemotherapy and radiation, uLMS remains a challenge to treat. In recent years, targeted therapies have been assessed in an effort to provide additional management options to reduce recurrence and improve survival. However, while clinical trials have shown targeted therapies to have activity in uLMS, survival benefits have not been observed. Given the overall meager impact of systemic therapy and radiation on survival in uLMS, surgical management remains an important component of multi-modality treatment.

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Chapter
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Publisher: Cambridge University Press
Print publication year: 2023

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References

Francis, M, et al. Incidence and survival of gynecologic sarcomas in England. Int J Gynecol Cancer 2015;25(5):850857.CrossRefGoogle ScholarPubMed
Kapp, DS, et al. Prognostic factors and survival in 1396 patients with uterine leiomyosarcomas: emphasis on impact of lymphadenectomy and oophorectomy. Cancer 2008;112(4):820830.CrossRefGoogle ScholarPubMed
Ghirardi, V, et al. Role of surgery in gynaecological sarcomas. Oncotarget 2019;10(26):25612575.CrossRefGoogle ScholarPubMed
Leitao, MM Jr., et al. Surgical cytoreduction in patients with metastatic uterine leiomyosarcoma at the time of initial diagnosis. Gynecol Oncol 2012;125(2):409413.CrossRefGoogle ScholarPubMed
George, S, et al. Soft tissue and uterine leiomyosarcoma. J Clin Oncol 2018;36(2):144150.CrossRefGoogle ScholarPubMed

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