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Uterine Sarcoma and Aromatase Inhibitors: Tom Baker Cancer Centre Experience and Review of the Literature

Altman, Alon D. MD, FRCSC*; Nelson, Gregg S. MD, PhD, FRCSC; Chu, Pamela MD, MBA, FRCSC; Nation, Jill MD, FRCSC; Ghatage, Prafull MBChB, FRCSC, FACOG

International Journal of Gynecological Cancer: July 2012 - Volume 22 - Issue 6 - p 1006–1012
doi: 10.1097/IGC.0b013e31825b7de8
Uterine Cancer

Objectives Uterine sarcomas are a rare group of mesenchymal tumors with a poor prognosis and aggressive biology. Standard treatment involves surgical staging. The role of further adjuvant treatment is unclear. The goals of this study were to determine the response rates to treatment of patients with uterine sarcomas and to review the currently available literature on the use of aromatase inhibitors (AIs).

Materials and Methods We performed a retrospective analysis on all patients with uterine sarcoma treated with an AI between 2000 and 2010 at the Tom Baker Cancer Centre in Calgary, Alberta.

Results Four patients with endometrial stromal sarcoma and 3 patients with leiomyosarcoma received treatment with an AI. A literature search resulted in 10 case reports and 4 retrospective studies of patients with endometrial stromal sarcoma and 1 case report and 2 retrospective studies of patients with leiomyosarcoma. On the basis of the available literature, combined with the current findings, the overall response rate of endometrial stromal sarcoma to AIs is 67% (complete response of 7% and partial response of 60%), and the partial response rate of leiomyosarcoma to AIs is 11%, with no reported complete responses.

Conclusions Aromatase inhibitors are a well-tolerated class of medications that are effective in the treatment of endometrial stromal sarcomas. These medications may also have a role to help stabilize disease progression in the treatment of leiomyosarcoma. More large, prospective, multicentered trials will be needed to clarify this issue.

*Winnipeg Health Sciences Centre & Cancer Care Manitoba, University of Manitoba, Winnipeg, Manitoba; and †Tom Baker Cancer Centre & Foothills Medical Centre, University of Calgary, Calgary, Alberta, Canada.

Address correspondence and reprint requests to Alon D. Altman, MD, FRCSC, RS406-810 Sherbrooke St, Winnipeg, Manitoba, Canada R3A 1R9. E-mail: alondaltman@gmail.com.

This research did not require any financial support and has not been presented at any national or international meetings or conferences.

The authors declare that there are no conflicts of interest.

Received February 28, 2012

Accepted April 20, 2012

Copyright © 2012 by IGCS and ESGO