The systemic treatment of uterine leiomyosarcomas: A systematic review. No news is good news?

Medicine (Baltimore). 2021 Apr 2;100(13):e25309. doi: 10.1097/MD.0000000000025309.


Background: Uterine leiomyosarcomas are rare malignant mesenchymal tumors. The systemic treatment of these tumors includes chemotherapy and radiotherapy. However, there are still a lot of unanswered questions regarding the ideal therapeutic approach.

Methods: We have conducted a systematic review of the treatment strategies of uterine leiomyosarcomas for the last ten years.

Results: Adjuvant chemotherapy is still a matter of dilemma. Doxorubicin based chemotherapy or the combination of Gemcitabine-Docetaxel are the regimens of choice for the first line setting. Beyond the first line, there are several options;, including chemotherapy, targeted therapy, and recently efforts of introducing immunotherapy to the therapeutic armamentarium of clinicians treating uterine leiomyosarcomas.

Conclusions: Despite the efforts of the clinicians dealing with uterine leiomyosarcomas, the optimal therapeutic algorithm is yet to be described.

Publication types

  • Systematic Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Chemotherapy, Adjuvant / methods*
  • Deoxycytidine / analogs & derivatives
  • Deoxycytidine / therapeutic use
  • Doxorubicin / therapeutic use
  • Female
  • Humans
  • Immunotherapy / methods*
  • Leiomyosarcoma / surgery*
  • Molecular Targeted Therapy / methods*
  • Treatment Outcome
  • Uterine Neoplasms / surgery*


  • Deoxycytidine
  • Doxorubicin
  • gemcitabine