Uterine Preservation Treatments in Sarcomas: Oncological Problems and Reproductive Results: A Systematic Review

Uterine sarcomas are rare cancers, sometimes diagnosed in women of childbearing age. Hysterectomy is the standard treatment in early stages. The option of lesion removal to save fertility is described in the literature, but it is still considered experimental. The objective of this systematic review...

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Autores principales:	Giulia Dondi, Eleonora Porcu, Alessandra De Palma, Giuseppe Damiano, Eugenia De Crescenzo, Linda Cipriani, Maria Dirodi, Gloria Ravegnini, Antonio De Leo, Margherita Nannini, Martina Ferioli, Alessio G. Morganti, Maria Abbondanza Pantaleo, Pierandrea De Iaco, Anna Myriam Perrone
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	fertility-sparing gynecological cancers sarcomas uterine cancers assisted reproductive treatments Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/bae5674429dd45e9b47b4b0d4e89961d
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spelling	oai:doaj.org-article:bae5674429dd45e9b47b4b0d4e89961d2021-11-25T17:04:15ZUterine Preservation Treatments in Sarcomas: Oncological Problems and Reproductive Results: A Systematic Review10.3390/cancers132258082072-6694https://doaj.org/article/bae5674429dd45e9b47b4b0d4e89961d2021-11-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/22/5808https://doaj.org/toc/2072-6694Uterine sarcomas are rare cancers, sometimes diagnosed in women of childbearing age. Hysterectomy is the standard treatment in early stages. The option of lesion removal to save fertility is described in the literature, but it is still considered experimental. The objective of this systematic review is to report on the available evidence on the reproductive and oncological outcomes of fertility-sparing treatment in women with uterine sarcomas. PubMed, Scopus and Cochrane Central Register of Controlled Trials were searched between 1 January 2011 and 21 June 2021 for publications in English about women with uterine sarcoma treated with a fertility-sparing intervention. Thirty-seven studies were included for a total of 210 patients: 63 low-grade endometrial stromal sarcomas, 35 embryonal rhabdomyosarcomas of the cervix, 19 adenosarcomas, 7 leiomyosarcomas and 2 uterine tumors resembling an ovarian sex cord. Conservative treatment ensured pregnancy in 32% of cases. In terms of oncological outcomes, relapse was related to histology and the worst prognosis was reported for leiomyosarcoma, followed by low-grade endometrial stromal sarcoma, which relapsed in 71% and 54% of cases, respectively. The highest death rate was associated with leiomyosarcoma (57.1%). This study demonstrated that fertility-sparing treatments may be employed in selected cases of early stage uterine sarcoma.Giulia DondiEleonora PorcuAlessandra De PalmaGiuseppe DamianoEugenia De CrescenzoLinda CiprianiMaria DirodiGloria RavegniniAntonio De LeoMargherita NanniniMartina FerioliAlessio G. MorgantiMaria Abbondanza PantaleoPierandrea De IacoAnna Myriam PerroneMDPI AGarticlefertility-sparinggynecological cancerssarcomasuterine cancersassisted reproductive treatmentsNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5808, p 5808 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	fertility-sparing gynecological cancers sarcomas uterine cancers assisted reproductive treatments Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	fertility-sparing gynecological cancers sarcomas uterine cancers assisted reproductive treatments Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Giulia Dondi Eleonora Porcu Alessandra De Palma Giuseppe Damiano Eugenia De Crescenzo Linda Cipriani Maria Dirodi Gloria Ravegnini Antonio De Leo Margherita Nannini Martina Ferioli Alessio G. Morganti Maria Abbondanza Pantaleo Pierandrea De Iaco Anna Myriam Perrone Uterine Preservation Treatments in Sarcomas: Oncological Problems and Reproductive Results: A Systematic Review
description	Uterine sarcomas are rare cancers, sometimes diagnosed in women of childbearing age. Hysterectomy is the standard treatment in early stages. The option of lesion removal to save fertility is described in the literature, but it is still considered experimental. The objective of this systematic review is to report on the available evidence on the reproductive and oncological outcomes of fertility-sparing treatment in women with uterine sarcomas. PubMed, Scopus and Cochrane Central Register of Controlled Trials were searched between 1 January 2011 and 21 June 2021 for publications in English about women with uterine sarcoma treated with a fertility-sparing intervention. Thirty-seven studies were included for a total of 210 patients: 63 low-grade endometrial stromal sarcomas, 35 embryonal rhabdomyosarcomas of the cervix, 19 adenosarcomas, 7 leiomyosarcomas and 2 uterine tumors resembling an ovarian sex cord. Conservative treatment ensured pregnancy in 32% of cases. In terms of oncological outcomes, relapse was related to histology and the worst prognosis was reported for leiomyosarcoma, followed by low-grade endometrial stromal sarcoma, which relapsed in 71% and 54% of cases, respectively. The highest death rate was associated with leiomyosarcoma (57.1%). This study demonstrated that fertility-sparing treatments may be employed in selected cases of early stage uterine sarcoma.
format	article
author	Giulia Dondi Eleonora Porcu Alessandra De Palma Giuseppe Damiano Eugenia De Crescenzo Linda Cipriani Maria Dirodi Gloria Ravegnini Antonio De Leo Margherita Nannini Martina Ferioli Alessio G. Morganti Maria Abbondanza Pantaleo Pierandrea De Iaco Anna Myriam Perrone
author_facet	Giulia Dondi Eleonora Porcu Alessandra De Palma Giuseppe Damiano Eugenia De Crescenzo Linda Cipriani Maria Dirodi Gloria Ravegnini Antonio De Leo Margherita Nannini Martina Ferioli Alessio G. Morganti Maria Abbondanza Pantaleo Pierandrea De Iaco Anna Myriam Perrone
author_sort	Giulia Dondi
title	Uterine Preservation Treatments in Sarcomas: Oncological Problems and Reproductive Results: A Systematic Review
title_short	Uterine Preservation Treatments in Sarcomas: Oncological Problems and Reproductive Results: A Systematic Review
title_full	Uterine Preservation Treatments in Sarcomas: Oncological Problems and Reproductive Results: A Systematic Review
title_fullStr	Uterine Preservation Treatments in Sarcomas: Oncological Problems and Reproductive Results: A Systematic Review
title_full_unstemmed	Uterine Preservation Treatments in Sarcomas: Oncological Problems and Reproductive Results: A Systematic Review
title_sort	uterine preservation treatments in sarcomas: oncological problems and reproductive results: a systematic review
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/bae5674429dd45e9b47b4b0d4e89961d
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Uterine Preservation Treatments in Sarcomas: Oncological Problems and Reproductive Results: A Systematic Review

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