Leiomyosarcoma surgery: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Leiomyosarcoma}} | {{Leiomyosarcoma}} | ||
{{CMG}} | {{CMG}}{{AE}} {{Nnasiri}} | ||
==Overview== | ==Overview== | ||
Patients with leiomyosarcoma have many treatment options. The selection depends on the stage of the tumor. The options are surgery, radiation therapy, chemotherapy, or a combination of these methods. | Patients with [[leiomyosarcoma]] have many treatment options but [[surgery]] is considered the mainstay of treatment for all soft tissue [[sarcoma]]<nowiki/>s. The selection depends on the stage of the tumor. The options are [[surgery]], [[radiation therapy]], [[chemotherapy]], or a combination of these methods. Treatment options are not chosen by the histological subtype of [[sarcoma]] but by tumor grade, size, and location of primary or [[metastatic]] disease. | ||
==Surgery== | ==Surgery== | ||
* | * [[Surgery]] is mainstay of therapy in leiomyosarcoma patients, in case of recurrence or progression of disease combination therapy with chemoradiation can be used as well. <ref name="pmid17338203">{{cite journal |vauthors=Vrzic-Petronijevic S, Likic-Ladjevic I, Petronijevic M, Argirovic R, Ladjevic N |title=Diagnosis and surgical therapy of uterine sarcoma |journal=Acta Chir Iugosl |volume=53 |issue=3 |pages=67–72 |date=2006 |pmid=17338203 |doi= |url=}}</ref> | ||
* [[Surgical]] resection of local recurrence and [[pulmonary]] [[metastases]] should be considered in individual patients.<ref name="GrimerJudson2010">{{cite journal|last1=Grimer|first1=Robert|last2=Judson|first2=Ian|last3=Peake|first3=David|last4=Seddon|first4=Beatrice|title=Guidelines for the Management of Soft Tissue Sarcomas|journal=Sarcoma|volume=2010|year=2010|pages=1–15|issn=1357-714X|doi=10.1155/2010/506182}}</ref> | |||
* [[Hysterectomy]] with bilateral [[salpingoophorectomy]] has been the main effective way of [[surgical]] therapy in patients with leiomyosarcoma.<ref name="urlTreatment for Uterine Sarcoma, by Type and Stage">{{cite web |url=https://www.cancer.org/cancer/uterine-sarcoma/treating/by-stage.html |title=Treatment for Uterine Sarcoma, by Type and Stage |format= |work= |accessdate=}}</ref> | |||
* [[Lymphadenectomy]] is generally not required as the [[tumor]] usually [[metastasize]] hematogenously and rarely through the [[lymph nodes]].<ref name="pmid18506484">Park JY, Kim DY, Suh DS, Kim JH, Kim YM, Kim YT et al. (2008) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=18506484 Prognostic factors and treatment outcomes of patients with uterine sarcoma: analysis of 127 patients at a single institution, 1989-2007.] ''J Cancer Res Clin Oncol'' 134 (12):1277-87. [http://dx.doi.org/10.1007/s00432-008-0422-2 DOI:10.1007/s00432-008-0422-2] PMID: [https://pubmed.gov/18506484 18506484]</ref><ref name="pmid14529683">Leitao MM, Sonoda Y, Brennan MF, Barakat RR, Chi DS (2003) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=14529683 Incidence of lymph node and ovarian metastases in leiomyosarcoma of the uterus.] ''Gynecol Oncol'' 91 (1):209-12. PMID: [https://pubmed.gov/14529683 14529683]</ref><ref name="urlUterine Sarcoma Stages">{{cite web |url=https://www.cancer.org/cancer/uterine-sarcoma/detection-diagnosis-staging/staging.html |title=Uterine Sarcoma Stages |format= |work= |accessdate=}}</ref> | |||
{{Family tree/start}} | |||
{{Family tree | | | | | | | B01 | | | |B01=[[Established stage]] based on the result of physical exam, imaging and biopsy}} | |||
{{Family tree | | |,|-|-|v|-|^|-|v|-|-|-|.| | }} | |||
{{Family tree | | C01 | | C02 | | C03 | | C04 | |C01=Stage 1 <br>low grade tumors|C02=Stage 2<br>less than 5 cm<br>high grade tumor|C03=Stage 3<br>more than 5 cm<br>high grade tumor or nodal disease|C04=Stage 4<br>distant metastasis}} | |||
{{Family tree | | |!| | | |!| | | |!| | | |!| | | |}} | |||
{{Family tree | | D01 | |D02| | D03 | | D04 | |D01=Surgical resection|D02=surgical resection<br>with or without radiation|D03=surgical resection with radiation<br>with or without chemotherapy|D04=chemotherapy<br>with or without surgical resection}} | |||
{{Family tree/end}} | |||
==References== | ==References== | ||
Latest revision as of 13:54, 19 March 2019
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Leiomyosarcoma Microchapters |
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Leiomyosarcoma surgery On the Web |
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American Roentgen Ray Society Images of Leiomyosarcoma surgery |
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Risk calculators and risk factors for Leiomyosarcoma surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Nima Nasiri, M.D.[2]
Overview
Patients with leiomyosarcoma have many treatment options but surgery is considered the mainstay of treatment for all soft tissue sarcomas. The selection depends on the stage of the tumor. The options are surgery, radiation therapy, chemotherapy, or a combination of these methods. Treatment options are not chosen by the histological subtype of sarcoma but by tumor grade, size, and location of primary or metastatic disease.
Surgery
- Surgery is mainstay of therapy in leiomyosarcoma patients, in case of recurrence or progression of disease combination therapy with chemoradiation can be used as well. [1]
- Surgical resection of local recurrence and pulmonary metastases should be considered in individual patients.[2]
- Hysterectomy with bilateral salpingoophorectomy has been the main effective way of surgical therapy in patients with leiomyosarcoma.[3]
- Lymphadenectomy is generally not required as the tumor usually metastasize hematogenously and rarely through the lymph nodes.[4][5][6]
| Established stage based on the result of physical exam, imaging and biopsy | |||||||||||||||||||||||||||||||||||||
| Stage 1 low grade tumors | Stage 2 less than 5 cm high grade tumor | Stage 3 more than 5 cm high grade tumor or nodal disease | Stage 4 distant metastasis | ||||||||||||||||||||||||||||||||||
| Surgical resection | surgical resection with or without radiation | surgical resection with radiation with or without chemotherapy | chemotherapy with or without surgical resection | ||||||||||||||||||||||||||||||||||
References
- ↑ Vrzic-Petronijevic S, Likic-Ladjevic I, Petronijevic M, Argirovic R, Ladjevic N (2006). "Diagnosis and surgical therapy of uterine sarcoma". Acta Chir Iugosl. 53 (3): 67–72. PMID 17338203.
- ↑ Grimer, Robert; Judson, Ian; Peake, David; Seddon, Beatrice (2010). "Guidelines for the Management of Soft Tissue Sarcomas". Sarcoma. 2010: 1–15. doi:10.1155/2010/506182. ISSN 1357-714X.
- ↑ "Treatment for Uterine Sarcoma, by Type and Stage".
- ↑ Park JY, Kim DY, Suh DS, Kim JH, Kim YM, Kim YT et al. (2008) Prognostic factors and treatment outcomes of patients with uterine sarcoma: analysis of 127 patients at a single institution, 1989-2007. J Cancer Res Clin Oncol 134 (12):1277-87. DOI:10.1007/s00432-008-0422-2 PMID: 18506484
- ↑ Leitao MM, Sonoda Y, Brennan MF, Barakat RR, Chi DS (2003) Incidence of lymph node and ovarian metastases in leiomyosarcoma of the uterus. Gynecol Oncol 91 (1):209-12. PMID: 14529683
- ↑ "Uterine Sarcoma Stages".