Table 8
From: UK guidelines for the management of soft tissue sarcomas
Key Recommendations : Gynaecologic Sarcomas |
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1) Standard treatment for all localised uterine sarcomas is total abdominal hysterectomy. Lymphadenectomy is not routinely indicated.(III,B) |
2) Total abdominal hysterectomy with bilateral oophorectomy is indicated for endometrial stromal sarcoma. These patients should not have post-operative hormone replacement therapy. Use of adjuvant oestrogen deprivation therapy is not indicated.(III,B) |
3) Adjuvant pelvic radiotherapy has not been shown to improve survival and is not routinely indicated in FIGO stage I and II disease. However, it could be considered for selected high-risk cases.(IV,C) |
4) Advanced/metastatic LMS and undifferentiated endometrial sarcoma are treated with the same drugs as STS at other sites. (IIIB) There is retrospective evidence that ifosfamide may be less effective in leiomyosarcoma (III,C). |
5) Advanced/metastatic ESS can be treated with oestrogen deprivation therapy, with an aromatase inhibitor or progestogen. Tamoxifen is not recommended since its action may be pro-oestrogenic (III,C). |
