Uterine sarcoma
Prepared with OnCo (onco.cc/prep/uterine-sarcoma/). Orientation, not medical advice; your team knows your case.
My details
What I know, what is unclear, changes to discuss
Saved in this browserMy questions
16 on the sheet- 1.What is my exact diagnosis, stage, and grade, and which tests established them?
- 2.Which biomarkers have been tested on my tumour (for example Histological subtype and mitotic count, Estrogen and progesterone receptor status, Fusion testing: JAZF1, YWHAE, BCOR, NTRK, ALK, Homologous recombination deficiency and BRCA alterations, Stage and whether the tumour was morcellated), and what were the results?
- 3.Which subtype is my cancer, and does that change the recommended treatment?
- 4.Is germline (inherited) genetic testing recommended for me or my family?
- 5.For my situation (localised, any subtype), which of the standard options do you recommend and why?
- 6.For my situation (advanced or recurrent leiomyosarcoma), which of the standard options do you recommend and why?
- 7.Am I a candidate for Doxorubicin, Trabectedin, Gemcitabine or related drugs, and what side effects should I expect?
- 8.For my situation (low-grade endometrial stromal sarcoma), which of the standard options do you recommend and why?
- 9.Am I a candidate for Letrozole (and other aromatase inhibitors), Progestins (megestrol acetate, medroxyprogesterone, levonorgestrel IUD), and what side effects should I expect?
- 10.For my situation (fusion-driven sarcoma), which of the standard options do you recommend and why?
- 11.Am I a candidate for Larotrectinib, Entrectinib, Crizotinib or related drugs, and what side effects should I expect?
- 12.Are there clinical trials I could join, for example of Trabectedin, Larotrectinib, Pazopanib?
- 13.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
- 14.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
- 15.I read that “Preoperative distinction of leiomyosarcoma from fibroids: MRI and LDH criteria and imaging AI are under study”. How does that affect my plan?
- 16.I read that “Advanced LMS remains chemoresistant after two lines: PARP inhibitors for the HRD subset and antibody-drug conjugates are in trials”. How does that affect my plan?
The words I may hear
- Hysterectomy: Removing the uterus (womb), often with the cervix, tubes and ovaries.
- Rare cancers: Rare cancers are those with fewer than about 6 new cases per 100,000 people per year.
Tests and results to bring
Biomarker results to ask for: Histological subtype and mitotic count, Estrogen and progesterone receptor status (ESS, some LMS), Fusion testing: JAZF1, YWHAE, BCOR, NTRK, ALK, Homologous recombination deficiency and BRCA alterations (subset of LMS), Stage and whether the tumour was morcellated.
Scans and tests linked to this cancer: Comprehensive genomic profiling, MRI.
Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.
The treatments I may be offered
- Localised, any subtype: Total hysterectomy with intact removal (no morcellation); bilateral salpingo-oophorectomy for ESS; observation after complete resection of stage I LMS because adjuvant chemotherapy (GOG-0277) and radiotherapy (EORTC 55874) did not improve survival. (Hysterectomy)
- Advanced or recurrent leiomyosarcoma: Doxorubicin alone or with trabectedin (LMS-04); gemcitabine-docetaxel; trabectedin, pazopanib or eribulin in later lines. (Doxorubicin, Trabectedin, Gemcitabine, Docetaxel, Pazopanib, Eribulin)
- Low-grade endometrial stromal sarcoma: Aromatase inhibitor (letrozole) or progestin; avoid estrogen and tamoxifen; surgery for resectable recurrence. (Letrozole (and other aromatase inhibitors), Progestins (megestrol acetate, medroxyprogesterone, levonorgestrel IUD), Endocrine therapy (SERMs, AIs, SERDs))
- Fusion-driven sarcoma: Larotrectinib or entrectinib for NTRK fusions, crizotinib or alectinib for ALK, imatinib for COL1A1-PDGFB. (Larotrectinib, Entrectinib, Crizotinib, Imatinib)
From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.