Hey thess-ga, how are you doing?
If you have questions about this topic, you can call the Cancer
Information Service at 1-800-4-CANCER (1-800-422-6237). The new
uterine neoplasm classification of the International Society of
Gynecologic Pathologists uses the term carcinosarcoma for all primary
uterine neoplasms containing malignant elements of both epithelial and
stromal light microscopic appearances, regardless of whether or not
malignant heterologous elements are present.
Stage III uterine sarcoma means extension outside of the uterus but
confined to the true pelvis. Staging is the process of determining the
extent of cancer in each patient as jointly evolved by The American
Joint Committee on Staging in conjunction with International Union
Against Cancer's TNM system language for clinical staging.
According to the new FIGO classification of corpus cancer endometrial
stromal sarcoma was considered clinical stage IIIA of low-grade. The
FIGO staging for carcinoma of the corpus uteri has been applied to
uterine sarcoma.
Medically suitable patients with the preoperative diagnosis of uterine
sarcoma are considered candidates for abdominal hysterectomy,
bilateral salpingo-oophorectomy, and pelvic and periaortic selective
lymphadenectomy. Thorough examination of the diaphragm, omentum, and
upper abdomen are performed.
Because the risk of disease recurrence is high even with localized
presentations, many physicians have considered the use of adjuvant
chemotherapy or radiation therapy. There is no firm evidence from a
prospective study that adjuvant chemotherapy or radiation therapy is
of benefit for patients with uterine sarcoma.
Stage III Uterine Sarcoma Standard treatment options:
1.) Surgery (total abdominal hysterectomy, bilateral
salpingo-oophorectomy, pelvic and periaortic selective
lymphadenectomy, and resection of all gross tumor).
2.) Surgery plus pelvic irradiation.
3.) Surgery plus adjuvant chemotherapy
Patients who present with measurable disease have been treated on a
series of Phase II studies by the Gynecologic Oncology Group (GOG).
Survival, however, was not improved by the addition of cisplatin, and
the authors concluded that use of the combination was not justified
because of increased toxic effects.
Progestins are related to progesterone which is produced by the corpus
luteum and placenta. They produce useful responses in 30 percent of
women with metastatic endometrial carcinoma.
Remissions may last for several years. The best results are seen in
older women with well-differentiated tumors who have had a long
interval between the appearance of the primary and recurrent disease.
Useful responses are also seen in about 20 percent of patients with
metastatic renal-cell carcinoma. Acute side effect of progestins is
minimal fluid retention and occasional hypercalcemia; thrombocytosis.
REFERENCES
The Association of Online Cancer Resources, Inc.: Uterine Sarcoma
http://www.acor.org/cnet/62938.html#_42
Southern Medical Association: Low-Grade Endometrial Stromal Sarcoma
Recurring After 9 Years
www.sma.org/smj2002/octsmj02/pdf/yokosuka.pdf
Vincent T. Devita, JR.: Staging And The TNM Classification/Progestins/Table 323-2
Harrision's Principles of Internal Medicine; Eight Edition; chap. 323
PRINCIPLES OF CANCER THERAPY, p. 1745-1755.
Best wishes, |
