Il ruolo della linfoadenectomia nella prognosi del sarcoma uterino

Abstract

Uterine sarcoma is a rare, but deadly disease. The uterine sarcoma is classified as leiomiosarcoma, endometrial stromal sarcoma, undifferentiated endometrial sarcoma, carcinosarcoma, and adenosarcoma. The most important symptoms are pre- and post-menopausal vaginal bleeding, abdominal pain, and abdominal distension. The best surgical approach is the histerectomy. Salpingo-oophorectomy is not necessary in premenopausal woman with early-stage leiomiosarcoma and endometrial stromal sarcoma. Routine lymphoadenectomy is discussed. Primary surgery with tumor-free resection margins, without residual disease is the main prognostic factor for the survival of the uterine sarcoma patient. It is also important that uterine sarcoma surgery might be centralized to institutions that have the necessary expertise in gynecological oncological surgery. Adjuvant pelvic irradiation can be considered if resection margins in the pelvis are involved. Introduction of irradiation therapy and chemioterapy has not influenced the long-term survival of these patients. Uterine sarcoma patients with extra-uterine disease have a poor prognosis. In our study we arroled 61 patients from 2000 to 2012, to find a correlation between the lymphoadenectomy, prognosis, and survival.