The management of patients with uterine sarcoma: A debated clinical challenge

Critical Reviews in Oncology/Hematology

Volumn 65, Issue 2, 2008, Pages 129-142

  Gadducci, Angiolo ^a   Cosio, Stefania ^a   Romanini, Antonella ^b   Genazzani, Andrea Riccardo ^a  

^a Div of Gynecology and Obstetrics   (Italy)

^b UNIVERSITY OF PISA   (Italy)

Author keywords

Carcinosarcoma; Chemotherapy; Endocrine therapy; Endometrial stromal sarcoma; Leiomyosarcoma; Molecularly targeted agents; Smooth muscle tumours of unknown malignant potential; Uterine sarcoma

Indexed keywords

AROMATASE INHIBITOR; CISPLATIN; DACARBAZINE; DACTINOMYCIN; DOCETAXEL; DOXORUBICIN; EPIRUBICIN; ETOPOSIDE; GEMCITABINE; GONADORELIN DERIVATIVE; IFOSFAMIDE; MEGESTROL ACETATE; PACLITAXEL; PROGESTERONE DERIVATIVE; TEMOZOLOMIDE; TOPOTECAN; VINCRISTINE;

ABDOMINAL HYSTERECTOMY; ADVANCED CANCER; ANEMIA; CANCER ADJUVANT THERAPY; CANCER CONTROL; CANCER GRADING; CANCER HORMONE THERAPY; CANCER PATIENT; CANCER RECURRENCE; CANCER STAGING; CARCINOSARCOMA; CYTOREDUCTIVE SURGERY; DECISION MAKING; EARLY CANCER; ENDOMETRIUM SARCOMA; HUMAN; INCIDENCE; LEIOMYOSARCOMA; LUNG METASTASIS; LYMPHADENECTOMY; MULTIPLE CYCLE TREATMENT; NEUROTOXICITY; PROGNOSIS; REVIEW; SALPINGOOOPHORECTOMY; SENSORY NEUROPATHY; SOFT TISSUE SARCOMA; TREATMENT INDICATION; TREATMENT OUTCOME; TREATMENT RESPONSE; UTERUS SARCOMA;

ANTINEOPLASTIC COMBINED CHEMOTHERAPY PROTOCOLS; FEMALE; HUMANS; NEOADJUVANT THERAPY; SARCOMA; TREATMENT OUTCOME; UTERINE NEOPLASMS;

EID: 37549048643     PISSN: 10408428     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.critrevonc.2007.06.011     Document Type: Review

References (177)

1. Harlow B.L., Weiss N.S., and Lofton S. The epidemiology of sarcomas of the uterus. J Natl Cancer Inst 76 (1986) 399-402
2. Nordal R.R., and Thoresen S.O. Uterine sarcomas in Norway 1956-1992: incidence, survival and mortality. Eur J Cancer 33 (1997) 907-911
3. Brooks S.E., Zhan M., Cote T., and Baquet C.R. Surveillance, epidemiology, and end results analysis of 2677 cases of uterine sarcoma 1989-1999. Gynecol Oncol 93 (2004) 204-208
4. Salazar O.M., and Dunne M.E. The role of radiation therapy in the management of uterine sarcomas. Int J Radiat Oncol Biol Phys 6 (1980) 899-902
5. Berchuck A., Rubin S.C., Hoskins W.J., Saigo P.E., Pierce V.K., and Lewis Jr. J.L. Treatment of uterine leiomyosarcoma. Obstet Gynecol 71 (1988) 845-850
6. Taina E., Maenpaa J., Erkkola R., Ikkala J., Soderstrom O., and Viitanen A. Endometrial stromal sarcoma: a report of nine cases. Gynecol Oncol 32 (1989) 156-162
7. Berchuck A., Rubin S.C., Hoskins W.J., Saigo P.E., Pierce V.K., and Lewis Jr. J.L. Treatment of endometrial stromal tumors. Gynecol Oncol 36 (1990) 60-65
8. Ali S., and Wells M. Mixed mullerian tumors of the uterine corpus: a review. Int J Gynecol Cancer 3 (1993) 1-11
9. Gadducci A., Landoni F., Sartori E., et al. Uterine leiomyosarcoma: analysis of treatment failures and survival. Gynecol Oncol 62 (1996) 25-32
10. Gadducci A., Sartori E., Landoni F., et al. Endometrial stromal sarcoma: analysis of treatment failures and survival. Gynecol Oncol 63 (1996) 247-253
11. Sartori E., Bazzurini L., Gadducci A., et al. Carcinosarcoma of the uterus: a clinicopathological multicenter CTF study. Gynecol Oncol 67 (1997) 70-75
12. Iwasa Y., Haga H., Konishi I., et al. Prognostic factors in uterine carcinosarcoma: a clinicopathologic study of 25 patients. Cancer 82 (1998) 512-519
13. Gadducci A., Sartori E., Landoni F., et al. The prognostic relevance of histological type in uterine sarcomas: a Cooperation Task Force (CTF) multivariate analysis of 249 cases. Eur J Gynaecol Oncol 23 (2002) 295-299
14. Jonson A.L., Bliss R.L., Truskinovsky A., et al. Clinical features and outcomes of uterine and ovarian carcinosarcoma. Gynecol Oncol 100 (2006) 561-564
15. Piver M.S., Rutledge F.N., Copeland L., Webster K., Blumenson L., and Suh O. Uterine endolymphatic stromal myosis: a collaborative study. Obstet Gynecol 64 (1984) 173-178
16. De Fusco P.A., Gaffey T.A., Malkasian Jr. G.D., Long H.J., and Cha S.S. Endometrial stromal sarcoma: review of Mayo Clinic experience, 1945-1980. Gynecol Oncol 35 (1989) 8-14
17. Oliva E., Clement P., and Young R.H. Endometrial stromal tumors: an update on a group of tumors with a protean phenotype. Adv Anat Pathol 7 (2000) 257-281
18. Amant F., Vergote I., and Moerman P. The classification of a uterine sarcoma as 'high-grade endometrial stromal sarcoma' should be abandoned. Gynecol Oncol 95 (2004) 412-413
19. Moinfar F., Azodi M., and Tavassoli F.A. Uterine sarcomas. Pathology 39 (2007) 55-71
20. Inayama Y., Shoji A., Odagiri S., et al. Detection of pulmonary metastasis of low-grade endometrial stromal sarcoma 25 years after hysterectomy. Pathol Res Pract 196 (2000) 129-134
21. Uchino M., Endo G., Shibata I., et al. Uterine leiomyosarcoma metastasis to the skull-case report. Neurol Med Chir 36 (1996) 469-471
22. Saiz A.D., Sachdev U., Brodman M.L., and Deligdisch L. Metastatic uterine leiomyosarcoma presenting as a primary sarcoma of the parotid gland. Obstet Gynecol 92 (1998) 667-668
23. Yokoyama Y., Ono Y., Sakamoto T., Fukuda I., and Mizunuma H. Asymptomatic intracardiac metastasis from a low-grade endometrial stromal sarcoma with successful surgical resection. Gynecol Oncol 92 (2004) 999-1001
24. M'sakni I., Bouraoui S., Ben slama S., et al. Duodenal metastatic leiomyosarcoma of the uterus. A case report. Ann Chir 130 (2005) 584-586
25. Iwamoto I., Fujino T., Higashi Y., et al. Metastasis of uterine leiomyosarcoma to the pancreas. J Obstet Gynaecol Res 31 (2005) 531-534
26. Falconi M., Crippa S., Sargenti M., Capelli P., and Pederzoli P. Pancreatic metastasis from leiomyosarcoma of the broad ligament of the uterus. Lancet Oncol 7 (2006) 94-95
27. Echt G., Jepson J., Steel J., et al. Treatment of uterine sarcomas. Cancer 66 (1990) 35-39
28. Wolfson A.H., Wolfson D.J., Sittler S.Y., et al. A multivariate analysis of clinicopathologic factors for predicting outcome in uterine sarcomas. Gynecol Oncol 52 (1994) 56-62
29. Olah K.S., Dunn J.A., and Gee H. Leiomyosarcomas have a poorer prognosis than mixed mesodermal tumours when adjusting for known prognostic factors: the result of a retrospective study of 423 cases of uterine sarcoma. Br J Obstet Gynaecol 99 (1992) 590-594
30. Wilkinson N., and Rollason T.P. Recent advanced in the pathology of smooth mucle tumours of the uterus. Histopathology 39 (2001) 331-341
31. Bell S.W., Kempson R.L., and Hendrickson M.R. Problematic uterine smooth muscle neoplasms. A clinicopathologic study of 213 cases. Am J Surg Pathol 18 (1994) 535-558
32. Al-Nafussi A. Uterine smooth-muscle tumours: practical approach to diagnosis. Curr Diagn Pathol 10 (2004) 140-156
33. Zaloudek C., and Hendrickson M.R. Mesenchymal tumors of the uterus. In: Kurman R.J. (Ed). Blaustein's pathology of the female genital tract (2002), Springer-Verlag, Inc., New York 561-615
34. Leibsohn S., d'Ablaing G., Mishell Jr. D.R., and Schlaerth J.B. Leiomyosarcoma in a series of hysterectomies performed for presumed uterine leiomyomas. Am J Obstet Gynecol 162 (1990) 968-976
35. Major F.J., Blessing J.A., Silverberg S.G., et al. Prognostic factors in early-stage uterine sarcoma. A Gynecologic Oncology Group study. Cancer 71 Suppl. 4 (1993) 1702-1709
36. Wade K., Quinn M.A., Hammond I., Williams K., and Cauchi M. Uterine sarcoma: steroid receptors and response to hormonal therapy. Gynecol Oncol 39 (1990) 364-367
37. Zhai Y.L., Kobayashi Y., Mori A., et al. Expression of steroid receptors, Ki-67, and p53 in uterine leiomyosarcomas. Int J Gynecol Pathol 18 (1999) 20-28
38. Mittal K., and Demopoulos R.I. MIB-1 (Ki-67), p53, estrogen receptor, and progesterone receptor expression in uterine smooth muscle tumors. Hum Pathol 32 (2001) 984-987
39. Kitaoka Y., Kitawaki J., Koshiba H., et al. Aromatase cytochrome P450 and estrogen and progesterone receptors in uterine sarcomas: correlation with clinical parameters. J Steroid Biochem Mol Biol 88 (2004) 183-189
40. Leitao M.M., Soslow R.A., Nonaka D., et al. Tissue microarray immunohistochemical expression of estrogen, progesterone, and androgen receptors in uterine leiomyomata and leiomyosarcoma. Cancer 101 (2004) 1455-1462
41. Akhan S.E., Yavuz E., Tecer A., et al. The expression of Ki-67, p53, estrogen and progesterone receptors affecting survival in uterine leiomyosarcomas. A clinicopathologic study. Gynecol Oncol 99 (2005) 36-42
42. Bodner K., Bodner-Adler B., Kimberger O., Czerwenka K., Leodolter S., and Mayerhofer K. Estrogen and progesterone receptor expression in patients with uterine leiomyosarcoma and correlation with different clinicopathological parameters. Anticancer Res 23 (2003) 729-732
43. Klein W.M., and Kurman R.J. Lack of expression of c-kit protein (CD117) in mesenchymal tumors of the uterus and ovary. Int J Gynecol Pathol 22 (2003) 181-184
44. Winter III W.E., Seidman J.D., Krivak T.C., et al. Clinicopathological analysis of c-kit expression in carcinosarcomas and leiomyosarcomas of the uterine corpus. Gynecol Oncol 91 (2003) 3-8
45. Wang L., Felix J.C., Lee J.L., Tan P.Y., Tourgeman D.E., O'Meara A.T., and Amezcua C.A. The proto-oncogene c-kit is expressed in leiomyosarcomas of the uterus. Gynecol Oncol 90 (2003) 402-406
46. Raspollini M.R., Amunni G., Villanucci A., Pinzani P., Simi L., Paglierani M., and Taddei G.L. c-Kit expression in patients with uterine leiomyosarcomas: a potential alternative therapeutic treatment. Clin Cancer Res 10 (2004) 3500-3503
47. Nakayama M., Mitsuhashi T., Shimizu Y., et al. Immunohistochemical evaluation of KIT expression in sarcomas of the gynecologic region. Int J Gynecol Pathol 25 (2006) 70-76
48. Rushing R.S., Shajahan S., Chendil D., et al. Uterine sarcomas express KIT protein but lack mutation(s) in exon 11 or 17 of c-KIT. Gynecol Oncol 91 (2003) 9-14
49. Raspollini M.R., Pinzani P., Simi L., et al. Uterine leiomyosarcomas express KIT protein but lack mutation(s) in exon 9 of c-KIT. Gynecol Oncol 98 (2005) 334-335
50. Serrano C., Mackintosh C., Herrero D., et al. Imatinib is not a potential alternative treatment for uterine leiomyosarcoma. Clin Cancer Res 11 (2005) 4977-4979
51. Amant F., Vloeberghs V., Woestenborghs H., et al. ERBB-2 gene overexpression and amplification in uterine sarcomas. Gynecol Oncol 95 (2004) 583-587
52. Sprogoe-Jakobsen S., and Holund B. Immunohistochemistry (Ki-67 and p53) as a tool in determining malignancy in smooth muscle neoplasms (exemplified by a myxoid leiomyosarcoma of the uterus). APMIS 104 (1996) 705-708
53. de Vos S., Wilczynski S.P., Fleischhacker M., and Koeffler P. p53 alterations in uterine leiomyosarcomas versus leiomyomas. Gynecol Oncol 54 (1994) 205-208
54. Jeffers M.D., Farquharson M.A., Richmond J.A., and McNicol A.M. p53 immunoreactivity and mutation of the p53 gene in smooth muscle tumours of the uterine corpus. J Pathol 177 (1995) 65-70
55. Hall K.L., Teneriello M.G., Taylor R.R., et al. Analysis of Ki-ras, p53, and MDM2 genes in uterine leiomyomas and leiomyosarcomas. Gynecol Oncol 65 (1997) 330-335
56. Anderson S.E., Nonaka D., Chuai S., et al. p53, epidermal growth factor, and platelet-derived growth factor in uterine leiomyosarcoma and leiomyomas. Int J Gynecol Cancer 16 (2006) 849-853
57. Mayerhofer K., Lozanov P., Bodner K., Bodner-Adler B., Kimberger O., and Czerwenka K. Ki-67 expression in patients with uterine leiomyomas, uterine smooth muscle tumors of uncertain malignant potential (STUMP) and uterine leiomyosarcomas (LMS). Acta Obstet Gynecol Scand 83 (2004) 1085-1088
58. Esposito N.N., Hunt J.L., Bakker A., and Jones M.W. Analysis of allelic loss as an adjuvant tool in evaluation of malignancy in uterine smooth muscle tumors. Am J Surg Pathol 30 (2006) 97-103
59. Cho Y.L., Bae S., Koo M.S., et al. Array comparative genomic hybridization analysis of uterine leiomyosarcoma. Gynecol Oncol 99 (2005) 545-551
60. Chang K.L., Crabtree G.S., Lim-Tan S.K., Kempson R.L., and Hendrickson M.R. Primary uterine endometrial stromal neoplasms. A clinicopathologic study of 117 cases. Am J Surg Pathol Am Pathol 14 (1990) 415-438
61. Montag T.W., and Manart F.D. Endolymphatic stromal myosis: surgical and hormonal therapy for extensive venous recurrence Gynecol. Oncology 33 (1989) 255-260
62. Reich O., Regauer S., Urdl W., Lahousen M., and Winter R. Expression of oestrogen and progesterone receptors in low-grade endometrial stromal sarcomas. Br J Cancer 82 (2000) 1030-1034
63. Chu M.C., Mor G., Lim C., Zheng W., Parkash V., and Schwartz P.E. Low-grade endometrial stromal sarcoma: hormonal aspects. Gynecol Oncol 90 (2003) 170-176
64. Schwartz P.E., Chu M.C., Zheng W., and Mor G. Endometrial stromal tumors-are they hormonally sensitive?. In: Genazzani A.R. (Ed). Hormone replacement therapy and cancer. The current status of research and practice (2002), The Parthenon Publishing Group, Boca Raton, London, New York, Washington DC 148-154
65. Balleine R.L., Earls P.J., Webster L.R., et al. Expression of progesterone receptor A and B isoforms in low-grade endometrial stromal sarcoma. Int J Gynecol Pathol 23 (2004) 138-144
66. Pink D., Lindner T., Mrozek A., et al. Harm or benefit of hormonal treatment in metastatic low-grade endometrial stromal sarcoma: single center experience with 10 cases and review of the literature. Gynecol Oncol 101 (2006) 464-469
67. Moinfar F., Gogg-Kamerer M., Sommersacher A., et al. Endometrial stromal sarcomas frequently express epidermal growth factor receptor (EGFR, HER-1): potential basis for a new therapeutic approach. Am J Surg Pathol 29 (2005) 485-489
68. Hurrell D., and McCluggage W.G. Uterine tumour resembling ovarian sex cord tumour is an immunohistochemically polyphenotypic neoplasm which exhibits coexpression of epithelial, myoid and sex cord markers. J Clin Pathol 60 (2007) 1148-1154
69. Hauptmann S., Nadjari B., Kraus J., Turnwald W., and Dietel M. Uterine tumor resembling ovarian sex-cord tumor-a case report and review of the literature. Virchows Arch 439 (2001) 97-101
70. Caudell J.J., Deavers M.T., Slomovitz B.M., et al. Imatinib mesylate (gleevec)-targeted kinases are expressed in uterine sarcomas. Appl Immunohistochem Mol Morphol 13 (2005) 167-170
71. Nielsen S.N., Podratz K.C., Scheithauer B.W., and O'Brien P.C. Clinicopathologic analysis of uterine malignant mixed mullerian tumors. Gynecol Oncol 34 (1989) 372-378
72. Yamada S.D., Burger R.A., Brewster W.R., Anton D., Kohler M.F., and Monk B.J. Pathologic variables and adjuvant therapy as predictors of recurrence and survival for patients with surgically evaluated carcinosarcoma of the uterus. Cancer 88 (2000) 2782-2786
73. Gorai I., Yanagibashi T., Taki A., et al. Uterine carcinosarcoma is derived from a single stem cell: an in vitro study. Int J Cancer 72 (1997) 821-827
74. Silverberg S.G., Major F.J., Blessing J.A., et al. Carcinosarcoma (malignant mixed mesodermal tumor) of the uterus. A Gynecologic Oncology Group pathologic study of 203 cases. Int J Gynecol Pathol 9 (1990) 1-19
75. Sreenan J.J., and Hart W.R. Carcinosarcomas of the female genital tract. A pathologic study of 29 metastatic tumors: further evidence for the dominant role of the epithelial component and the conversion theory of histogenesis. Am J Surg Pathol 19 (1995) 666-674
76. Jansen R.L., van der Burg M.E., Verweij J., and Stoter G. Cyclophosphamide, hexamethylmelamine, adriamycin and cisplatin combination chemotherapy in mixed mesodermal sarcoma of the female genital tract. Eur J Cancer Clin Oncol 23 (1987) 1131-1133
77. Peters III W.A., Rivkin S.E., Smith M.R., and Tesh D.E. Cisplatin and adriamycin combination chemotherapy for uterine stromal sarcomas and mixed mesodermal tumors. Gynecol Oncol 34 (1989) 323-327
78. Thigpen J.T., Blessing J.A., Beecham J., Homesley H., and Yordan E. Phase II trial of cisplatin as first-line chemotherapy in patients with advanced or recurrent uterine sarcomas: a Gynecologic Oncology Group study. J Clin Oncol 9 (1991) 1962-1966
79. Baker T.R., Piver M.S., Caglar H., and Piedmonte M. Prospective trial of cisplatin, adriamycin, and dacarbazine in metastatic mixed mesodermal sarcomas of the uterus and ovary. Am J Clin Oncol 14 (1991) 246-250
80. Vaccarello L., and Curtin J.P. Presentation and management of carcinosarcoma of the uterus. Oncology 6 (1992) 45-49
81. van Rijswijk R.E., Tognon G., Burger C.W., Baak J.P., Kenemans P., and Vermorken J.B. The effect of chemotherapy on the different components of advanced carcinosarcomas (malignant mixed mesodermal tumors) of the female genital tract. Int J Gynecol Cancer 4 (1994) 52-60
82. Arrastia C.D., Fruchter R.G., Clark M., et al. Uterine carcinosarcomas: incidence and trends in management and survival. Gynecol Oncol 65 (1997) 158-163
83. van Rijswijk R.E., Vermorken J.B., Reed N., et al. Cisplatin, doxorubicin and ifosfamide in carcinosarcoma of the female genital tract. A phase II study of the European Organization for Research and Treatment of Cancer Gynaecological Cancer Group (EORTC 55923). Eur J Cancer 39 (2003) 481-487
84. Sutton G., Kauderer J., Carson L.F., Lentz S.S., Whitney C.W., Gallion H., and Gynecologic Oncology Group. Adjuvant ifosfamide and cisplatin in patients with completely resected stage I or II carcinosarcomas (mixed mesodermal tumors) of the uterus: a Gynecologic Oncology Group study. Gynecol Oncol 96 (2005) 630-634
85. Östör A.G., and Rollason T.P. Mixed tumours of the uterus. In: Fox H., and Wells M. (Eds). Obstet. gynaecol. pathol. 4th ed. Vol. 1 (1995), Haines and Taylor, Churchill Livingstone, New York 606-610
86. Longracre T.A., Kempson R.L., and Hendrickson M.R. Endometrial hyperplasia, metaplasia, and carcinoma. In: Fox H., and Wells M. (Eds). Obstet. gynaecol. pathol. 4th ed. Vol. 1 (1995), Haines and Taylor, Churchill Livingstone, New York 421-510
87. Emoto M., Charnock-Jones D.S., Licence D.R., et al. Localization of the VEGF and angiopoietin genes in uterine carcinosarcoma. Gynecol Oncol 95 (2004) 474-482
88. George E., Lillemoe T.J., Twiggs L.B., and Perrone T. Malignant mixed mullerian tumor versus high-grade endometrial carcinoma and aggressive variants of endometrial carcinoma: a comparative analysis of survival. Int J Gynecol Pathol 14 (1995) 39-44
89. Amant F., Cadron I., Fuso L., et al. Endometrial carcinosarcomas have a different prognosis and pattern of spread compared to high-risk epithelial endometrial cancer. Gynecol Oncol 98 (2005) 274-280
90. Sawada M., Tsuda H., Kimura M., et al. Different expression patterns of KIT, EGFR, and HER-2 (c-erbB-2) oncoproteins between epithelial and mesenchymal components in uterine carcinosarcoma. Cancer Sci 94 (2003) 986-991
91. Menczer J., Kravtsov V., Levy T., Berger E., Glezerman M., and Avinoach I. Expression of c-kit in uterine carcinosarcoma. Gynecol Oncol 96 (2005) 210-215
92. Raspollini M.R., Susini T., Amunni G., et al. COX-2, c-KIT and HER-2/neu expression in uterine carcinosarcomas: prognostic factors or potential markers for targeted therapies?. Gynecol Oncol 96 (2005) 159-167
93. Riben M.W., Malfetano J.H., Nazeer T., Muraca P.J., Ambros R.A., and Ross J.S. Identification of HER-2/neu oncogene amplification by fluorescence in situ hybridization in stage I endometrial carcinoma. Mod Pathol 10 (1997) 823-831
94. Rolitsky C.D., Theil K.S., McGaughy V.R., Copeland L.J., and Niemann T.H. HER-2/neu amplification and overexpression in endometrial carcinoma. Int J Gynecol Pathol 18 (1999) 138-143
95. Livasy C.A., Reading F.C., Moore D.T., Boggess J.F., and Lininger R.A. EGFR expression and HER2/neu overexpression/amplification in endometrial carcinosarcoma. Gynecol Oncol 100 (2006) 101-106
96. Raspollini M.R., Susini T., Amunni G., et al. Expression and amplification of HER-2/neu oncogene in uterine carcinosarcomas: a marker for potential molecularly targeted treatment?. Int J Gynecol Cancer 16 (2006) 416-422
97. Mayall F., Rutty K., Campbell F., and Goddard H. p53 immunostaining suggests that uterine carcinosarcomas are monoclonal. Histopathology 24 (1994) 211-214
98. Seki A., Kodama J., Miyagi Y., Kamimura S., Yoshinouchi M., and Kudo T. Amplification of the mdm-2 gene and p53 abnormalities in uterine sarcomas. Int J Cancer 73 (1997) 33-37
99. Abargel A., Avinoach I., Kravtsov V., Boaz M., Glezerman M., and Menczer J. Expression of p27 and p53: comparative analysis of uterine carcinosarcoma and endometrial carcinoma. Int J Gynecol Cancer 14 (2004) 354-359
100. Taylor N.P., Zighelboim I., Huettner P.C., et al. DNA mismatch repair and TP53 defects are early events in uterine carcinosarcoma tumorigenesis. Mod Pathol 19 (2006) 1333-1338
101. Mutter G.L., Lin M.C., Fitzgerald J.T., et al. Altered PTEN expression as a diagnostic marker for the earliest endometrial precancers. J Natl Cancer Inst 92 (2000) 924-930
102. Terakawa N., Kanamori Y., and Yoshida S. Loss of PTEN expression followed by Akt phosphorylation is a poor prognostic factor for patients with endometrial cancer. Endocr Relat Cancer 10 (2003) 203-208
103. Amant F., de la Rey M., Dorfling C.M., et al. PTEN mutations in uterine sarcomas. Gynecol Oncol 85 (2002) 165-169
104. Gadducci A., Cosio S., and Genazzani A.R. Old and new perspectives in the pharmacological treatment of advanced or recurrent endometrial cancer: hormonal therapy, chemotherapy and molecularly targeted therapies. Crit Rev Oncol Hematol 58 (2006) 242-256
105. Giuntoli II R.L., Metzinger D.S., DiMarco C.S., et al. Retrospective review of 208 patients with leiomyosarcoma of the uterus: prognostic indicators, surgical management, and adjuvant therapy. Gynecol Oncol 89 (2003) 460-469
106. Morice P., Rodrigues A., Pautier P., et al. Surgery for uterine sarcoma: review of the literature and recommendations for the standard surgical procedure. Gynecol Obstet Fertil 31 (2003) 147-150
107. Dinh T.A., Oliva E.A., Fuller Jr. A.F., Lee H., and Goodman A. The treatment of uterine leiomyosarcoma. Results from a 10-year experience (1990-1999) at the Massachusetts General Hospital. Gynecol Oncol 92 (2004) 648-652
108. Benoit L., Arnould L., Cheynel N., et al. The role of surgery and treatment trends in uterine sarcoma. Eur J Surg Oncol 31 (2005) 434-442
109. Menczer J., Levy T., Piura B., et al. A comparison between different postoperative treatment modalities of uterine carcinosarcoma. Gynecol Oncol 97 (2005) 166-170
110. Wu T.I., Chang T.C., Hsueh S., et al. Prognostic factors and impact of adjuvant chemotherapy for uterine leiomyosarcoma. Gynecol Oncol 100 (2006) 166-172
111. Giuntoli II R.L., and Bristow R.E. Uterine leiomyosarcoma: present management. Curr Opin Oncol 16 (2004) 324-327
112. Goff B.A., Rice L.W., Fleischhacker D., et al. Uterine leiomyosarcoma and endometrial stromal sarcoma: lymph node metastases and sites of recurrence. Gynecol Oncol 50 (1993) 105-109
113. Gard G.B., Mulvany N.J., and Quinn M.A. Management of uterine leiomyosarcoma in Australia. Aust N Z J Obstet Gynaecol 39 (1999) 93-98
114. Lissoni A., Cormio G., Bonazzi C., et al. Fertility-sparing surgery in uterine leiomyosarcoma. Gynecol Oncol 70 (1998) 348-350
115. Marshburn P.B., Matthews M.L., and Hurst B.S. Uterine artery embolization as a treatment option for uterine myomas. Obstet Gynecol Clin North Am 33 (2006) 125-144
116. Joyce A., Hessami S., and Heller D. Leiomyosarcoma after uterine artery embolization. A case report. J Reprod Med 46 (2001) 278-280
117. Temkin S.M., Hellmann M., Lee Y.C., and Abulafia O. Early-stage carcinosarcoma of the uterus: the significance of lymph node count. Int J Gynecol Cancer 17 (2007) 215-219
118. Li A.J., Giuntoli II R.L., Drake R., et al. Ovarian preservation in stage I low-grade endometrial stromal sarcomas. Obstet Gynecol 106 (2005) 1304-1308
119. Riopel J., Plante M., Renaud M.C., Roy M., and Tetu B. Lymph node metastases in low-grade endometrial stromal sarcoma. Gynecol Oncol 96 (2005) 402-406
120. Reich O., Winter R., and Regauer S. Should lymphadenectomy be performed in patients with endometrial stromal sarcoma?. Gynecol Oncol 97 (2005) 982-983
121. Kohorn E.I., Schwartz P.E., Chambers J.T., Peschel R.E., Kapp D.S., and Merino M. Adjuvant therapy in mixed mullerian tumors of the uterus. Gynecol Oncol 23 (1986) 212-221
122. Chi D.S., Mychalczak B., Saigo P.E., Rescigno J., and Brown C.L. The role of whole-pelvic irradiation in the treatment of early-stage uterine carcinosarcoma. Gynecol Oncol 65 (1997) 493-498
123. Bodner-Adler B., Bodner K., Obermair A., et al. Prognostic parameters in carcinosarcomas of the uterus: a clinico-pathologic study. Anticancer Res 21 (2001) 3069-3074
124. Dusenbery K.E., Potish R.A., Argenta P.A., and Judson P.L. On the apparent failure of adjuvant pelvic radiotherapy to improve survival for women with uterine sarcomas confined to the uterus. Am J Clin Oncol 28 (2005) 295-300
125. Livi L., Andreopoulou E., Shah N., et al. Treatment of uterine sarcoma at the Royal Marsden Hospital from 1974 to 1998. Clin Oncol 16 (2004) 261-268
126. Gerszten K., Faul C., Kounelis S., Huang Q., Kelley J., and Jones M.W. The impact of adjuvant radiotherapy on carcinosarcoma of the uterus. Gynecol Oncol 68 (1998) 8-13
127. Larson B., Silfversward C., Nilsson B., and Pettersson F. Mixed mullerian tumours of the uterus-prognostic factors: a clinical and histopathologic study of 147 cases. Radiother Oncol 17 (1990) 123-132
128. Le T. Adjuvant pelvic radiotherapy for uterine carcinosarcoma in a high risk population. Eur J Surg Oncol 27 (2001) 282-285
129. Hoffmann W., Schmandt S., Kortmann R.D., Schiebe M., Dietl J., and Bamberg M. Radiotherapy in the treatment of uterine sarcomas. A retrospective analysis of 54 cases. Gynecol Obstet Invest 42 (1996) 49-57
130. Knocke T.H., Kucera H., Dorfler D., Pokrajac B., and Potter R. Results of postoperative radiotherapy in the treatment of sarcoma of the corpus uteri. Cancer 83 (1998) 1972-1979
131. Reed N., Mangioni C., Malmstrom H., et al. First results of a randomized trial comparing radiotherapy versus observation postoperatively in patients with uterine sarcomas. An EORTC-GCG study. Int J Gynaecol Cancer 13 Suppl. 1 (2003) 4 [abs. pl12]
132. Patel S.R., Vadhan-Raj S., Papadopolous N., et al. High-dose ifosfamide in bone and soft tissue sarcomas: results of phase II and pilot studies-dose-response and schedule dependence. J Clin Oncol 15 (1997) 2378-2384
133. Patel S.R. Dose-intensive chemotherapy for soft tissue sarcomas. In: Perry M.C. (Ed). American society of clinical oncology-2000 educational book, thirty-sixth annual meeting May 19-23. New Orleans, LA (2000) 453-457
134. Bramwell V., Quirt I., Warr D., et al. Combination chemotherapy with doxorubicin, dacarbazine, and ifosfamide in advanced adult soft tissue sarcoma. Canadian Sarcoma Group-National Cancer Institute of Canada Clinical Trials Group. J Natl Cancer Inst 81 (1989) 1496-1499
135. Elias A., Ryan L., Sulkes A., Collins J., Aisner J., and Antman K.H. Response to mesna, doxorubicin, ifosfamide, and dacarbazine in 108 patients with metastatic or unresectable sarcoma and no prior chemotherapy. J Clin Oncol 7 (1989) 1208-1216
136. Antman K., Crowley J., Balcerzak S.P., et al. An intergroup phase III randomized study of doxorubicin and dacarbazine with or without ifosfamide and mesna in advanced soft tissue and bone sarcomas. J Clin Oncol 11 (1993) 1276-1285
137. Edmonson J.H., Ryan L.M., Blum R.H., et al. Randomized comparison of doxorubicin alone versus ifosfamide plus doxorubicin or mitomycin, doxorubicin, and cisplatin against advanced soft tissue sarcomas. J Clin Oncol 11 (1993) 1269-1275
138. Santoro A., Tursz T., Mouridsen H., et al. Doxorubicin versus CYVADIC versus doxorubicin plus ifosfamide in first-line treatment of advanced soft tissue sarcomas: a randomized study of the European Organization for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group. J Clin Oncol 13 (1995) 1537-1545
139. Almeida G.F., Castro Jr. G., Snitcovsky I.M., Bassani A.C., Diz M.E., and Federico M.H. Ifosfamide (IFO) and doxorubicin (DOX) dose-intensities seem related to overall survival in adult soft-tissue sarcoma (STS) patients. ASCO Annual Meeting Proceedings, Part 1. J Clin Oncol 24 June 20 Supplement (2006) [abstract 9581]
140. Kanjeekal S., Chambers A., Fung M.F., and Verma S. Systemic therapy for advanced uterine sarcoma: a systematic review of the literature. Gynecol Oncol 97 (2005) 624-637
141. Omura G.A., Major F.J., Blessing J.A., et al. A randomized study of adriamycin with and without dimethyl triazenoimidazole carboxamide in advanced uterine sarcomas. Cancer 52 (1983) 626-632
142. Sutton G.P., Blessing J.A., Barrett R.J., and McGehee R. Phase II trial of ifosfamide and mesna in leiomyosarcoma of the uterus: a Gynecologic Oncology Group study. Am J Obstet Gynecol 166 (1992) 556-559
143. Sutton G., Blessing J.A., Park R., DiSaia P.J., and Rosenshein N. Ifosfamide treatment of recurrent or metastatic endometrial stromal sarcomas previously unexposed to chemotherapy: a study of the Gynecologic Oncology Group. Obstet Gynecol 87 (1996) 747-750
144. Sutton G.P., Blessing J.A., Rosenshein N., Photopulos G., and DiSaia P.J. Phase II trial of ifosfamide and mesna in mixed mesodermal tumors of the uterus (a Gynecologic Oncologic Group study). Am J Obstet Gynecol 161 (1989) 309-312
145. Sutton G., Blessing J.A., and Malfetano J.H. Ifosfamide and doxorubicin in the treatment of advanced leiomyosarcomas of the uterus: a Gynecologic Oncology Group Study. Gynecol Oncol 62 (1996) 226-229
146. Leyvraz S., Bacchi M., Cerny T., et al. Phase I multicenter study of combined high-dose ifosfamide and doxorubicin in the treatment of advanced sarcomas. Swiss Group for Clinical Research (SAKK). Ann Oncol 9 (1998) 877-884
147. Sutton G., Blessing J., Hanjani P., and Kramer P. Gynecologic Oncology Group. Phase II evaluation of liposomal doxorubicin (Doxil) in recurrent or advanced leiomyosarcoma of the uterus: a Gynecologic Oncology Group study. Gynecol Oncol 96 (2005) 749-752
148. Look K.Y., Sandler A., Blessing J.A., Lucci III J.A., and Rose P.G. Gynecologic Oncology Group (GOG) Study. Phase II trial of gemcitabine as second-line chemotherapy of uterine leiomyosarcoma: a Gynecologic Oncology Group (GOG) Study. Gynecol Oncol 92 (2004) 644-647
149. Hensley M.L., Maki R., Venkatraman E., et al. Gemcitabine and docetaxel in patients with unresectable leiomyosarcoma: results of a phase II trial. J Clin Oncol 20 (2002) 2824-2831
150. Anderson S., and Aghaianian C. Temozolomide in uterine leiomyosarcomas. Gynecol Oncol 98 (2005) 99-103
151. Favette J., Coquard I.R., Alberti L., et al. ET-743: a novel agent with activity in soft-tissue sarcomas. Curr Opin Oncol 18 (2006) 347-353
152. Grosso F., Demetri G.D., Blay J.Y., et al. Patterns of tumor response to trabectedin (ET743) in myxoid liposarcomas. ASCO Annual Meeting Proceedings, Part 1. J Clin Oncol 24 June 20 Suppl. (2006) [abstract 9511]
153. Yovine A., Riofrio M., Blay J.Y., et al. Phase II study of ecteinascidin-743 in advanced pretreated soft tissue sarcoma patients. J Clin Oncol 22 (2004) 890-899
154. Curtin J.P., Blessing J.A., Soper J.T., and DeGeest K. Paclitaxel in the treatment of carcinosarcoma of the uterus: a gynecologic oncology group study. Gynecol Oncol 83 (2001) 268-270
155. Toyoshima M., Akahira J., Matsunaga G., et al. Clinical experience with combination paclitaxel and carboplatin therapy for advanced or recurrent carcinosarcoma of the uterus. Gynecol Oncol 94 (2004) 774-778
156. Homesley H.D., Filiaci V., Markman M., et al. Phase III trial of ifosfamide with or without paclitaxel in advanced uterine carcinosarcoma: a Gynecologic Oncology Group Study. J Clin Oncol 25 (2007) 526-531
157. Miller D.S., Blessing J.A., Schilder J., Munkarah A., and Lee Y.C. Phase II evaluation of topotecan in carcinosarcoma of the uterus: a Gynecologic Oncology Group study. Gynecol Oncol 98 (2005) 217-221
158. Adjuvant, chemotherapy for localised resectable soft tissue sarcoma in adults. Sarcoma Meta-Analysis Collaboration (SMAC). Cochrane Database Syst Rev 2000; CD001419.
159. Frustaci S., Gherlinzoni F., De Paoli A., et al. Adjuvant chemotherapy for adult soft tissue sarcomas of the extremities and girdles: results of the Italian randomized cooperative trial. J Clin Oncol 19 (2001) 1238-1247
160. Frustaci S., De Paoli A., Bidoli E., et al. Ifosfamide in the adjuvant therapy of soft tissue sarcomas. Oncology 65 Suppl. 2 (2003) 80-84
161. Omura G.A., Blessing J.A., Major F., et al. A randomized clinical trial of adjuvant adriamycin in uterine sarcomas: a Gynecologic Oncology Group Study. J Clin Oncol 3 (1985) 1240-1245
162. van Nagell Jr. J.R., Hanson M.B., Donaldson E.S., and Gallion H.H. Adjuvant vincristine, dactinomycin, and cyclophosphamide therapy in stage I uterine sarcomas. A pilot study. Cancer 57 (1986) 1451-1454
163. Hempling R.E., Piver M.S., and Baker T.R. Impact on progression-free survival of adjuvant cyclophosphamide, vincristine, doxorubicin (adriamycin), and dacarbazine (CYVADIC) chemotherapy for stage I uterine sarcoma. A prospective trial. Am J Clin Oncol 18 (1995) 282-286
164. Resnik E., Chambers S.K., Carcangiu M.L., Kohorn E.I., Schwartz P.E., and Chambers J.T. A phase II study of etoposide, cisplatin, and doxorubicin chemotherapy in mixed mullerian tumors (MMT) of the uterus. Gynecol Oncol 56 (1995) 370-375
165. Manolitsas T.P., Wain G.V., Williams E.V., Freidlander M., and Hacker N.F. Multimodality therapy for patients with clinical stage I and II malignant mixed Mullerian tumors of the uterus. Cancer 91 (2001) 1437-1443
166. Gadducci A., and Romanini A. Adjuvant chemotherapy in early stage uterine sarcomas: an open question. Eur J Gynaecol Oncol 22 (2001) 352-357
167. Odunsi K., Moneke V., Tammela J., et al. Efficacy of adjuvant CYVADIC chemotherapy in early-stage uterine sarcomas: results of long-term follow-up. Int J Gynecol Cancer 14 (2004) 659-664
168. Pautier P., Rey A., Haie-Meder C., Kerbrat P., et al. Adjuvant chemotherapy with cisplatin, ifosfamide, and doxorubicin followed by radiotherapy in localized uterine sarcomas: results of a case-control study with radiotherapy alone. Int J Gynecol Cancer 14 (2004) 1112-1117
169. Wolfson A.H., Brady M.F., Rocereto T.F., et al. A Gynecologic Oncology Group randomized trial of whole abdominal irradiation (WAI) vs. cisplatin-ifosfamide + mesna (CIM) in optimally debulked stage I-IV carcinosarcoma (CS) of the uterus. ASCO Annual Meeting Proceedings, Part 1. J Clin Oncol 24 June 20 Suppl. (2006) [abstract 5001]
170. Paillocher N., Lortholary A., Abadie-Lacourtoisie S., et al. Low-grade endometrial stromal sarcoma: contribution of hormone therapy and etoposide. J Gynecol Obstet Biol Reprod 34 (2005) 41-46
171. Scribner Jr. D.R., and Walker J.L. Low-grade endometrial stromal sarcoma preoperative treatment with Depo-Lupron and Megace. Gynecol Oncol 71 (1998) 458-460
172. Burke C., and Hickey K. Treatment of endometrial stromal sarcoma with a gonadotropin-releasing hormone analogue. Obstet Gynecol 104 (2004) 1182-1184
173. Maluf F.C., Sabbatini P., Schwartz L., Xia J., and Aghajanian C. Endometrial stromal sarcoma: objective response to letrozole. Gynecol Oncol 82 (2001) 384-388
174. Spano J.P., Soria J.C., Kambouchner M., et al. Long-term survival of patients given hormonal therapy for metastatic endometrial stromal sarcoma. Med Oncol 20 (2003) 87-93
175. Schwartz L.B., Diamond M.P., and Schwartz P.E. Leiomyosarcomas: clinical presentation. Am J Obstet Gynecol 168 (1993) 180-183
176. Levenback C., Rubin S.C., McCormack P.M., Hoskins W.J., Atkinson E.N., and Lewis Jr. J.L. Resection of pulmonary metastases from uterine sarcomas. Gynecol Oncol 45 (1992) 202-205
177. Anderson T.M., McMahon J.J., Nwogu C.E., et al. Pulmonary resection in metastatic uterine and cervical malignancies. Gynecol Oncol 83 (2001) 472-476