Advancements in uterine sarcoma management: A review

Eur J Surg Oncol. 2025 Apr;51(4):109646. doi: 10.1016/j.ejso.2025.109646. Epub 2025 Jan 28.

Abstract

Uterine sarcomas are rare, accounting for 3-7% of uterine malignancies. This review aims to summarize advancements in diagnostics and treatment over the last decade, focusing on innovative imaging techniques, molecular diagnostics, and treatment modalities. Recent diagnostic advancements include enhanced imaging techniques such as MRI and AI-driven algorithms, improving accuracy in differentiating between benign and malignant uterine tumors. Biomarkers like lactate dehydrogenase (LDH) and microRNAs have shown potential in preoperative identification. Treatment strategies continue to evolve, with surgical resection being the cornerstone. The role of lymphadenectomy and adnexectomy varies by histopathological subtype, emphasizing personalized approaches. Adjuvant therapies remain controversial, tailored to patient risk factors and tumor characteristics. Fertility-sparing options are viable for selected patients, though not recommended for high-grade tumors. Significant progress in diagnostic techniques and personalized treatment approaches has improved the management of uterine sarcomas. Future guidelines from major oncology groups are expected to standardize care. Continued research is essential for refining treatment protocols and enhancing patient outcomes.

Keywords: Artificial intelligence; Molecular diagnostics; Treatment approaches; Uterine sarcomas.

Publication types

  • Review

MeSH terms

  • Female
  • Humans
  • Leiomyosarcoma / diagnosis
  • Leiomyosarcoma / therapy
  • Lymph Node Excision
  • Magnetic Resonance Imaging
  • Sarcoma* / diagnosis
  • Sarcoma* / pathology
  • Sarcoma* / therapy
  • Uterine Neoplasms* / diagnosis
  • Uterine Neoplasms* / pathology
  • Uterine Neoplasms* / therapy