Advances in Treatment of Uterine Sarcoma
Uterine sarcomas present challenges for many patients. Even at an early stage, many of these cancers can return at a later point (recur). Compared to endometrial cancer (a cancer arising from the lining surface of the uterus), women with uterine sarcomas are often diagnosed in a more advanced stage as the cancer has already spread.
Because of these two factors, additional treatments following surgery are frequntly recommended. Researchers always look for new ways to treat this cancer. They may also try new combinations of older treatments. Researchers also look back at health records to find patterns of the treatments that seemed to work best. Here are some recent advances researchers have found.
- Expert surgical care in one step that may lead to better outcomes for patients with uterine sarcoma. Surgeons trained in removing lymph nodes or removing cancer that has spread in the abdominal cavity (such as gynecologic oncologists) can offer patients the most aggressive approaches to the management of uterine sarcomas.
- Following surgery, some patients with uterine sarcoma require additional treatments with chemotherapy, radiation, or hormonal therapy. Treatments depend on the specific type of uterine sarcoma.
- The Gynecologic Oncology Group has conducted several studies looking for better treatments for patients with carcinosarcoma of the uterus (also called mixed mullerian tumor, MMT). In one study the chemotherapy treatment of ifosphamide plus cisplatin was compared to abdominal and pelvic radiation in patients with stage I-IV cancer who had a surgery which removed all/most of the cancer. In this large study, chemotherapy proved to be superior. In a second study of patients with cancer that returned (recurrent disease) or who had very advanced disease, the chemotherapy ifosphamide was compared to ifosphamide plus paclitaxel. The addition of paclitaxel to ifosphamide resulted in better outcomes for patients.
- Current studies in uterine carcinosarcoma are evaluating different chemotherapy combinations, the role of adding radiation with chemotherapy.
- For patients with a uterine sarcoma arising form the uterine muscular wall (leiomyosarcoma) a new combination of drugs using gemcitabine and doctetaxel are producing exciting results. Several research groups are studying this combination.
