Update on treatment of uterine sarcoma

Uterine sarcoma is a rare but extremely aggressive subtype of uterine malignancy. This heterogeneous group of tumors consists of several histologic types, including carcinosarcoma, leiomyosarcoma, and endometrial stromal sarcoma. Because of tumor rarity and histopathologic diversity, no standardized treatment for any histologic type has yet been established. In this review, we discuss recent studies and update the management of uterine sarcomas.

The recent trend is to treat each histologic type separately. New International Federation of Obstetrics and Gynecology staging systems unique to each histologic type have been developed. Prospective and retrospective studies have focused primarily on adjuvant therapy after surgical resection.

Surgery remains the mainstay of treatment for uterine sarcoma, demonstrating a curative potential regardless of histologic type. Effective adjuvant therapy to prolong survival has not yet been established. Because neither currently available radiation therapy nor different combinations of cytotoxic chemotherapeutic agents is likely to have a major impact on the course of uterine sarcoma, alternative approaches such as molecularly targeted therapies need to be explored.