ESGO/EURACAN/GCIG guidelines for the management of patients with uterine sarcomas

Abstract

A collaboration was established between the European Society of Gynaecological Oncology (ESGO), the European Reference Network on Rare Adult Solid Cancers (EURACAN), and the Gynecologic Cancer InterGroup (GCIG) with the aim of developing clinically relevant, evidence-based consensus guidelines on the management of patients with uterine sarcomas from diagnosis to relapse.ESGO/EURACAN/GCIG nominated practicing clinicians from centers of expertise in the management of patients with uterine sarcomas to serve on the expert panel (25 experts). To ensure that the statements were evidence-based, data identified from a systematic search were reviewed and critically appraised. In the absence of robust scientific evidence, clinical recommendations were based on the consensus of the international development group. Prior to publication, the guidelines were reviewed by 104 independent international clinicians with expertise in uterine sarcomas.Attention was given to imaging, pathology, and molecular analyses in addition to clinical management. Recommendations for surgery, including specific recommendations at initial diagnosis and at relapse, were developed. Indications for radiation and systemic therapies, including chemotherapy options, endocrine therapies, and targeted therapies, were addressed for the following histological subgroups of uterine sarcomas: high-grade endometrial stromal sarcomas, undifferentiated sarcomas, low-grade endometrial stromal sarcomas, uterine leiomyosarcomas, adenosarcomas, and selected very rare entities. Recommendations for follow-up and highlighted issues and unmet needs faced by long-term survivors were also discussed.