Patient's question:
These past few months, my menstrual cycle has been very irregular, sometimes coming every ten days, and the duration of my period has also increased significantly, with the flow coming in intermittent bursts and not stopping completely. I then went to the hospital for a check-up, and the results showed that I had uterine leiomyosarcoma, which scared me greatly.Doctor's answer:
1. Surgical TreatmentThe surgical approach should be determined based on the pathological type and stage of the tumor. For Stage I, a total hysterectomy with bilateral adnexectomy is performed. For cervical sarcoma, Stage II uterine sarcoma, and carcinosarcoma, a comprehensive hysterectomy with bilateral adnexectomy and pelvic lymph node dissection should be conducted, supplemented by chemotherapy or radiotherapy before and after surgery. Routine collection of pelvic and abdominal lavage fluid for cytological examination is performed during the operation. Ovarian preservation is limited to young patients with early, low-grade malignant leiomyosarcoma. For young patients who have undergone myomectomy and are diagnosed with leiomyoma malignancy postoperatively, if the lesion is localized, low-grade, with intact pseudocapsule, and without vascular involvement, close follow-up may be considered.
2. Radiotherapy
It is generally believed that uterine sarcoma is not sensitive to radiotherapy. Except for palliative treatment in advanced stages, it is not selected as a standalone treatment method. However, postoperative radiotherapy can achieve certain efficacy, improving the 5-year survival rate. Radiotherapy also has a certain effect on recurrent or unresectable lesions.