Case 2 – Adjuvant treatment of high-grade uterine leiomyosarcoma: a still open question

Abstract

We report a case of localized high-grade uterine leiomyosarcoma treated with surgery after massive bleeding and then with adjuvant chemotherapy with gemcitabine and dacarbazine for six cycles, after multidisciplinary evaluation and discussion with the patient. Adjuvant chemotherapy in uterine sarcomas is still debated, as in all soft-tissue sarcomas, although the risk of recurrence is often high; no adjuvant medical treatment is considered standard since there are no trials demonstrating that adjuvant chemotherapy improves outcome, compared with surgical resection alone. We show that the association of gemcitabine and dacarbazine for six cycles is a feasible adjuvant treatment in this setting, with no relevant side effects.