Abstract：
UNASSIGNED: The cornerstone of treatment for uterine sarcoma, regardless of histologic type, remains en bloc surgical resection with total hysterectomy. In the case of incidental diagnosis during another procedure, such as myomectomy, where a hysterectomy was not performed initially, completion hysterectomy or cervical remnant removal is recommended. The completion of additional surgical procedures, including bilateral salpingo-oophorectomy and lymphadenectomy, remains nuanced. Bilateral salpingo-oophorectomy remains controversial in the setting of most subtypes of uterine sarcoma, except in the case of hormone-receptor positivity, such as in low grade endometrial stromal sarcoma, where it is indicated as part of definitive surgical treatment. In the absence of apparent nodal involvement, we do not recommend performing universal lymphadenectomy for patients with sarcoma. We recommend systemic therapy for patients with extra-uterine or advanced stage disease, high-grade histology, and recurrence. The most active chemotherapy regimens for advanced, high-grade disease remain doxorubicin or gemcitabine and docetaxol combination therapy. A notable exception is low grade endometrial stromal sarcoma, where we recommend anti-hormonal therapy in the front-line setting. Radiation therapy is reserved for selected cases where it can aid in palliating symptoms.
摘要：
■子宫肉瘤治疗的基石，无论组织学类型，仍然是全子宫切除术的整体手术切除。在另一个过程中偶然诊断的情况下，比如子宫肌瘤切除术,最初没有进行子宫切除术，建议完成子宫切除术或切除宫颈残留物。完成额外的外科手术，包括双侧输卵管卵巢切除术和淋巴结清扫术，仍然细微差别。在大多数子宫肉瘤亚型的背景下，双侧输卵管卵巢切除术仍存在争议。除了激素受体阳性，如低级别子宫内膜间质肉瘤，在那里它是作为确定的手术治疗的一部分。在没有明显节点参与的情况下，我们不建议对肉瘤患者进行普遍的淋巴结清扫术.我们建议对子宫外或晚期疾病的患者进行系统治疗，高级组织学，和复发。最积极的晚期化疗方案，高级别疾病仍然是阿霉素或吉西他滨和多西紫杉醇联合治疗。一个值得注意的例外是低级别子宫内膜间质肉瘤，我们建议在一线进行抗激素治疗。放射治疗是保留在选定的情况下，它可以帮助缓解症状。
