子宫癌肉瘤（英文）.pdf

Curr. Treat. Options in Oncol. (2015) 16: 53 DOI 10.1007/s11864-015-0370-4 Gynecologic Cancers (RJ Morgan, Section Editor) Review of Recommended Treatment of Uterine Carcinosarcoma Joseph Menczer, MD Address Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, E. Wolfson Medical Center, Holon, Israel Email: joseph12@internet-zahav.net Published online: 15 September 2015 * Springer Science+Business Media New York 2015 This article is part of the Topical Collection on Gynecologic Cancers Keywords Uterine carcinosarcoma I Treatment I Surgery I Adjuvant treatment I Radiotherapy I Chemotherapy I Multimodal adjuvant treatment I Targeted I Therapy Opinion statement Surgery is the primary treatment for uterine carcinosarcoma (UCS). Lymphadenec- tomy should be performed for staging purposes in tumors apparently confined to the uterus. Most studies found that lymphadenectomy is of therapeutic value. The therapeutic value of cytoreduction to no residual macroscopic disease in advanced UCS is based mostly on small retrospective uncontrolled studies. Postoperative adjuvant therapy should be considered for all stages of UCS. Adjuvant pelvic radiotherapy may reduce locoregional recurrences. However, this does not trans- late into improved overall survival since most recurrences are distant outside the irradiated field, and the survival rates remain poor, the 5-year overall survival being about 50 %. Several adjuvant platin-based combination chemotherapy schedules such as cisplatin/ifosfamide, ifosfamide/paclitaxel, and paclitaxel/ carboplatin have been found to be an effective mode of adjuvant treatment. Multimodal therapy (i.e., adjuvant chemotherapy plus radiotherapy) has also been shown to be effective.