Gynaecological Oncology Fellow.
Management of Uterine Leiomyosarcoma in Australia
Article first published online: 28 JUL 2009
© 1999 Royal Australian and New Zealand College of Obstetricians and Gynaecologists
Australian and New Zealand Journal of Obstetrics and Gynaecology
Volume 39, Issue 1, pages 93–98, February 1999
How to Cite
Card, G. B., Mulvany, N. J. and Quinn, M. A. (1999), Management of Uterine Leiomyosarcoma in Australia. Australian and New Zealand Journal of Obstetrics and Gynaecology, 39: 93–98. doi: 10.1111/j.1479-828X.1999.tb03453.x
- Issue published online: 28 JUL 2009
- Article first published online: 28 JUL 2009
Summary: Uterine leiomyosarcoma is an uncommon malignancy for which the management varies widely between individual gynaecologists and gynaecological oncology units. We have performed a retrospective review of patients treated at both the Royal Women's Hospital in Melbourne (1970–1997) and King George V Hospital in Sydney (1987–1993). In addition we have performed a survey of Certified Gynaecological Oncologists (CGO's) to assess the current management of uterine leiomyosarcomas in Australia. The results show varied management practices exist in Australia, many of which are not supported by evidence in the current literature. Oophorectomy in the premenopausal patient appears unnecessary unless the ovaries are macroscopically involved. The role of pelvic lymphadenectomy is debatable. This practice was recommended by many CGO's, yet these nodes are rarely positive unless obvious extrauterine disease is present. Adjuvant chemotherapy appears not to have a role at present unless in a trial setting. Adjuvant radiotherapy does appear to have a potential palliative role as it prevents locoregional relapse, although survival is not prolonged. Until suitable phase 3 trials are available, gynaecological oncology units should be meticulous in prospectively recording the clinical course of their patients and critically analyzing their current management strategies.