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Maligne, nichtepitheliale Tumoren des Corpus uteri

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Book cover Praxisbuch Gynäkologische Onkologie

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Zusammenfassung

Uterine Sarkome stellen eine heterogene Gruppe von Neoplasien dar, welche etwa 8% der Malignome des Uterus ausmachen. Am häufigsten sind die Karzinosarkome [früher maligne, gemischte mesenchymale Tumoren (MMMT) des Uterus], die etwa 40–50% aller Sarkome stellen. Leiomyosarkome sind am zweithäufigsten und endometriale Stromasarkome am seltensten. Ein ausgedehntes operatives Staging inklusive Lymphadenektomie ist beim Karzinosarkom indiziert. Beim Leiomyosarkom wird eine abdominale Hysterektomie mit beidseitiger Adnexektomie ohne pelvine Lymphonodektomie empfohlen, da ein Lymphknotenbefall extrem selten ist. Bei jungen Patientinnen ist es zulässig, makroskopisch unauffällige Ovarien zu erhalten. Beim endometranen Stromasarkom ist die Hysterektomie mit beidseitiger Adnexektomie die Therapie der Wahl. Eine adjuvante Therapie ist beim Uterussarkom nicht etabliert. Low-grade endometriale Stromasarkome zeigen ein Ansprechen auf eine Hormontherapie.

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Literatur

  • Berchuck A, Rubin SC, Hoskins WJ, Saigo PE, Pierce VK, Lewis JL Jr (1990) Treatment of endometrial stromal tumors. Gynecol Oncol 36: 60–65

    Article  PubMed  CAS  Google Scholar 

  • Berchuck A, Rubin SC, Hoskins WJ, Saigo PE, Pierce VK, Lewis JL Jr (1988) Treatment of uterine leiomyosarcoma. Obstet Gynecol 71: 845–50

    PubMed  CAS  Google Scholar 

  • Bodner K, Bodner-Adler B, Obermair A et al. (2001) Prognostic parameters in endometrial stromal sarcoma: a clinicopathologic study in 31 patients. Gynecol Oncol 81: 160–165

    Article  PubMed  CAS  Google Scholar 

  • Brooks SE, Zhan M, Cote T, Baquet CR (2004).Surveillance, epidemiology, and end results analysis of 2677 cases of uterine sarcoma 1989–1999.Gynecol Oncol 93: 204–208

    Article  PubMed  Google Scholar 

  • Burns B, Curry RH, Bell ME (1979) Morphologic features of prognostic significance in uterine smooth muscle tumors: a review of eighty-four cases. Am J Obstet Gynecol 135: 109–114

    PubMed  CAS  Google Scholar 

  • Chang KL, Crabtree GS, Lim-Tan SK, Kempson RL, Hendrickson MR (1990) Primary uterine endometrial stromal neoplasms. A clinicopathologic study of 117 cases. Am J Surg Pathol 14: 415–438

    PubMed  CAS  Google Scholar 

  • Chi DS, Mychalczak B, Saigo PE, Rescigno J, Brown CL (1997) The role of whole-pelvic irradiation in the treatment of early-stage uterine carcinosarcoma. Gynecol Oncol 65: 493–498

    Article  PubMed  CAS  Google Scholar 

  • Clement PB, Scully RE (1990) Müllerian adenosarcoma of the uterus: a clinicopathologic study of 100 cases with a review of the literature. Hum Pathol 21: 363–381

    Article  PubMed  CAS  Google Scholar 

  • Dinh TV, Slavin RE, Bhagavan BS, Hannigan EV, Tiamson EM, Yandell RB (1989) Mixed Mullerian tumors of the uterus: a clinicopathologic study. Obstet Gynecol 74: 388–392

    PubMed  CAS  Google Scholar 

  • Edmonson JH, Blessing JA, Cosin JA, Miller DS, Cohn DE, Rotmensch J (2002) Phase II study of mitomycin, doxorubicin, and cisplatin in the treatment of advanced uterine leiomyosarcoma: a Gynecologic Oncology Group study. Gynecol Oncol 85: 507–510

    Article  PubMed  CAS  Google Scholar 

  • Evans HL, Chawla SP, Simpson C, Finn KP (1988) Smooth muscle neoplasms of the uterus other than ordinary leiomyoma. A study of 46 cases, with emphasis on diagnostic criteria and prognostic factors. Cancer 62: 2239–2247

    PubMed  CAS  Google Scholar 

  • Evans MJ, Langlois NE, Kitchener HC, Miller ID (1995) Is there an association between long-term tamoxifen treatment and the development of carcinosarcoma (malignant mixed Mullerian tumor) of the uterus? Int J Gynecol Cancer 5: 310–313

    Article  PubMed  Google Scholar 

  • Gadducci A, Sartori E, Landoni F et al. (1996) Endometrial stromal sarcoma: analysis of treatment failures and survival. Gynecol Oncol 63: 247–253

    Article  PubMed  CAS  Google Scholar 

  • Gerszten K, Faul C, Kounelis S, Huang Q, Kelley J, Jones MW (1998) The impact of adjuvant radiotherapy on carcinosarcoma of the uterus. Gynecol Oncol 68: 8–13

    Article  PubMed  CAS  Google Scholar 

  • Giuntoli RL 2nd, Metzinger DS, DiMarco CS et al. (2003) Retrospective review of 208 patients with leiomyosarcoma of the uterus: prognostic indicators, surgical management, and adjuvant therapy. Gynecol Oncol 89: 460–469

    Article  PubMed  Google Scholar 

  • Goff BA, Rice LW, Fleischhacker D et al. (1993) Uterine leiomyosarcoma and endometrial stromal sarcoma: lymph node metastases and sites of recurrence. Gynecol Oncol 50: 105–109

    Article  PubMed  CAS  Google Scholar 

  • Hendrickson MR, Tavassoli FA, Kempson RL, McCluggage WG, Haller U, Kubik-Huch RA (2003) Mesenchymal tumours and related lesions. In: Tavassoli FA, Devilee P (eds) Tumours of the breast and female genital organs. IARC Press, Lyon, pp 233–244

    Google Scholar 

  • Hensley ML, Maki R, Venkatraman E et al. (2002) Gemcitabine and docetaxel in patients with unresectable leiomyosarcoma: results of a phase II trial. J Clin Oncol 20: 2824–2831

    Article  PubMed  CAS  Google Scholar 

  • Jones MW, Norris HJ (1995) Clinicopathologic study of 28 uterine leiomyosarcomas with metastasis. Int J Gynecol Pathol 14: 243–249

    PubMed  CAS  Google Scholar 

  • Kaku T, Silverberg SG, Major FJ, Miller A, Fetter B, Brady MF (1992) Adenosarcoma of the uterus: a Gynecologic Oncology Group clinicopathologic study of 31 cases. Int J Gynecol Pathol 11: 75–88

    PubMed  CAS  Google Scholar 

  • Larson B, Silfversward C, Nilsson B, Pettersson F (1990) Prognostic factors in uterine leiomyosarcoma. A clinical and histopathological study of 143 cases. The Radiumhemmet series 1936–1981. Acta Oncol 29: 185–191

    PubMed  CAS  Google Scholar 

  • Leitao MM, Sonoda Y, Brennan MF, Barakat RR, Chi DS (2003) Incidence of lymph node and ovarian metastases in leiomyosarcoma of the uterus. Gynecol Oncol 91: 209–212

    Article  PubMed  Google Scholar 

  • Lissoni A, Cormio G, Perego P, Gabriele A, Cantu MG, Bratina G (1997) Conservative management of endometrial stromal sarcoma in young women. Int J Gynecol Cancer 7: 364–367

    Article  Google Scholar 

  • Lissoni A, Cormio G, Bonazzi C et al. (1998) Fertility-sparing surgery in uterine leiomyosarcoma. Gynecol Oncol 70: 348–350

    Article  PubMed  CAS  Google Scholar 

  • Major FJ, Blessing JA, Silverberg SG et al. (1993) Prognostic factors in early-stage uterine sarcoma. A Gynecologic Oncology Group study. Cancer 71: 1702–1709

    PubMed  CAS  Google Scholar 

  • Manolitsas TP, Wain GV, Williams KE, Freidlander M, Hacker NF (2001) Multimodality therapy for patients with clinical stage I and II malignant mixed Müllerian tumors of the uterus. Cancer 91: 1437–1443

    Article  PubMed  CAS  Google Scholar 

  • McCluggage WG, Haller U, Kurman RJ, Kubik-Huch RA (2003) Mixed epithelial and mesenchymal tumours. In: Tavassoli FA, Devilee P (eds) Tumours of the breast and female genital organs. IARC Press, Lyon, pp 245–249

    Google Scholar 

  • Muss HB, Bundy BN, DISaia PJ et al. (1985) Treatment of recurrent or advanced uterine sarcoma: a randomized trial of doxorubicin versus doxorubicin and cyclophosphamide: a phase III trial of the Gynecologic Oncology Group. Cancer 55: 1648–1653

    PubMed  CAS  Google Scholar 

  • Nordal RN, Kjorstad KE, Stenwig AE, Trope CG (1993) Leiomyosarcoma (LMS) and endometrial stromal sarcoma (ESS) of the uterus. A survey of patients treated in the Norwegian Radium Hospital 1976–1985. Int J Gynecol Cancer 3: 110–115

    Article  PubMed  Google Scholar 

  • Okuno S, Edmonson J, Mahoney M, Buckner JC, Frytak S, Galanis E (2002) Phase II trial of gemcitabine in advanced sarcomas. Cancer 94: 3225–3229

    Article  PubMed  CAS  Google Scholar 

  • Omura GA, Major FJ, Blessing JA et al. (1983) A randomized study of adriamycin with and without dimethyl triazenoimidazole carboxamide in advanced uterine sarcomas. Cancer 52: 626–632

    PubMed  CAS  Google Scholar 

  • Omura GA, Blessing JA, Major FA (1985) A randomized clinical trial of adjuvant adriamycin in uterine sarcomas: a Gynecologic Oncology Group study. J Clin Oncol 3: 1240–1245

    PubMed  CAS  Google Scholar 

  • Parker WH, Fu YS, Berek JS (1994) Uterine sarcoma in patients operated on for presumed leiomyoma and rapidly growing leiomyoma. Obstet Gynecol 83: 414–418

    PubMed  CAS  Google Scholar 

  • Peters WA 3rd, Howard DR, Andersen WA, Figge DC (1994) Uterine smooth-muscle tumors of uncertain malignant potential. Obstet Gynecol 83: 1015–1020

    Article  PubMed  Google Scholar 

  • Silverberg SG, Major FJ, Blessing JA et al. (1990) Carcinosarcoma (malignant mixed mesodermal tumor) of the uterus. A Gynecologic Oncology Group pathologic study of 203 cases. Int J Gynecol Pathol 9: 1–19

    Article  PubMed  CAS  Google Scholar 

  • Sreenan JJ, Hart WR (1995) 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: 666–674

    Article  PubMed  CAS  Google Scholar 

  • Sutton GP, Blessing JA, Barrett RJ, McGehee R (1992) Phase II trial of ifosfamide and mesna in leiomyosarcoma of the uterus: a Gynecologic Oncology Group study. Am J Obstet Gynecol 166: 556–559

    PubMed  CAS  Google Scholar 

  • Sutton G, Blessing JA, Malfetano JH (1996a) Ifosfamide and doxorubicin in the treatment of advanced leiomyosarcomas of the uterus: a Gynecologic Oncology Group study. Gynecol Oncol 62: 226–229

    Article  PubMed  CAS  Google Scholar 

  • Sutton G, Blessing JA, Park R, DiSaia PJ, Rosenshein N (1996b) Ifosfamide treatment of recurrent or metastatic endometrial stromal sarcomas previously unexposed to chemotherapy: a study of the Gynecologic Oncology Group. Obstet Gynecol 87: 747–750

    Article  PubMed  CAS  Google Scholar 

  • Sutton GP, Blessing JA, Carson LF, Lentz SS, Whitney CW, Gallion HH (1997) Adjuvant ifosfamide, mesna, and cisplatin in patients with completely resected stage I or II carcinosarcoma of the uterus: a Gynecologic Oncology Group study. Proc ASCO 16: 362a

    Google Scholar 

  • Sutton G, Brunetto VL, Kilgore L et al. (2000) A phase III trial of ifosfamide with or without cisplatin in carcinosarcoma of the uterus: a Gynecologic Oncology Group study. Gynecol Oncol 79: 147–1453

    Article  PubMed  CAS  Google Scholar 

  • Tsang RW, Fyles AW, Kirkbride P et al. (1995) Proliferation measurements with flow cytometry T pot in cancer of the uterine cervix: correlation between two laboratories and preliminary clinical results. Int J Radiat Oncol Biol Phys 32: 1319–1329

    Article  PubMed  CAS  Google Scholar 

  • Wade K, Quinn MA, Hammond I, Williams K, Cauchi M (1990) Uterine sarcoma: steroid receptors and response to hormonal therapy. Gynecol Oncol 39: 364–367

    Article  PubMed  CAS  Google Scholar 

  • Weitmann HD, Knocke TH, Kucera H, Potter R (2001) Radiation therapy in the treatment of endometrial stromal sarcoma. Int J Radiat Oncol Biol Phys 49: 739–48

    Article  PubMed  CAS  Google Scholar 

  • Yamada SD, Burger RA, Brewster WR, Anton D, Kohler MF, Monk BJ (2000) Pathologic variables and adjuvant therapy as predictors of recurrence and survival for patients with surgically evaluated carcinosarcoma of the uterus. Cancer 88: 2782–2786

    Article  PubMed  CAS  Google Scholar 

  • Zaloudek CJ, Norris HJ (1981) Adenofibroma and adenosarcoma of the uterus: a clinicopathologic study of 35 cases. Cancer 48: 354–366

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Zürich Klinik für Gynäkologie, Universitätsspital, Frauenklinikstraße 10, 8091, Zürich, Schweiz

    Priv.-Doz. Dr. med. Mathias K. Fehr & Prof. Dr. med. Daniel Fink

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  1. Priv.-Doz. Dr. med. Mathias K. Fehr
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  2. Prof. Dr. med. Daniel Fink
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© 2005 Springer Medizin Verlag Heidelberg

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Fehr, M.K., Fink, D. (2005). Maligne, nichtepitheliale Tumoren des Corpus uteri. In: Praxisbuch Gynäkologische Onkologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-30015-5_3

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  • DOI: https://doi.org/10.1007/3-540-30015-5_3

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-25667-0

  • Online ISBN: 978-3-540-30015-1

  • eBook Packages: Medicine (German Language)

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