價Check for updatesTHERAPEUTIC ADVANCES inMedical OncologyReviewUterine sarcomas:clinical practiceTherAdv Med Oncol2023.VoL.15:1-19guidelines for diagnosis,treatment,D0l:10.1177/1758835931157645The Authoris],2023.and follow-up,by Spanish group forArticle reuse guidelines:sagepub.com/journals-research on sarcomas(GEIS)permissionsJose Alejandro Perez-Fidalgo,Eugenia Ortega,Jordi Ponce,Andres Redondo,Isabel Sevilla,Claudia Valverde,Josep Isern Verdum,Enrique de Alava,Mar Galera Lopez,Gloria Marquina and Ana SebioAbstract:Uterine sarcomas are very infrequent and heterogeneous entities.Due to its rarity.pathological diagnosis,surgical management,and systemic treatment are challenging.Treatment decision process in these tumors should be taken in a multidisciplinary tumorboard.Available evidence is low and,in many cases,based on case series or clinical trials inCorrespondence to:which these tumors have been included with other soft tissue sarcoma.In these quidelines,Jose Alej归ndrowe have tried to summarize the most relevant evidence in the diagnosis,staging.pathologicalPerez-F月dalgoOncology and Hematologydisparities,surgical management,systemic treatment,and follow-up of uterine sarcomas.Department,INCLIVABiomedical ResearchInstitute.Hospital CinicUniersitano CIBERONCKeywords:adenosarcoma,endometrial stromal sarcoma,guidelines,leiomyosarcoma,Spain,Avda Blasco lbanezPEComa,uterine sarcoma17.Valencia,46010,Spainjapfidalgofamsn.comEugenia OrtegaReceived:12 July 2022;revised manuscript accepted:30 January 2023.Medical OncologyDepartment,HospitalUniversitario MiguelServet,Zaragoza,SpainJordi PonceIntroductionDiagnosis and staging of uterine sarcomasGynecology DepartmentUterine sarcomas are uncommon soft tissueSpecific clinical and radiological criteria to differ-Hospital Universitariode Bellvitge.IDIBELL.malignancies with an annual incidence of 0.36-entiate uterine sarcomas from benign uterine leio-Universidad de Barcelona.0.64 cases per 100.000 women in the Unitedmyomas are lacking.In both entities,abnormalBarcelona,SpainStates.!Diagnosis and pathological classificationvaginal bleeding,pelvic pain,and abdominalAndres RedondoMedical Oncologyof uterine sarcomas is a challenge.The most fre-mass are the most common symptoms.A rapidlyDepartment,Hospitalquent subtypes are leiomyosarcoma (LMS),fol-growing uterine fibroid in a peri-menopausal orUniversitario La Paz-IdiPAZ,Madrid,Spainlowed by endometrial stromal sarcoma(ESS)andpostmenopausal woman should raise suspicion ofIsabel Sevillaundifferentiated uterine sarcoma (UUS).sarcoma.3CLinical andHistological grade deeply impacts on prognosisTranslational Researchin Cancer/Institutoand clinical behavior.While high-grade ESSsThe first approach to diagnosis is usually a pelvicde Investigaciones(HG-ESS)are generally highly aggressive,low-ultrasound followed by pelvic magnetic resonanceBiomedicas de Malaga[IBIMAl/Hospitalesgrade ESSs (LG-ESSs)have an indolent behav-imaging (MRD.4 Algorithms may help to differ-Universitari
