Treatment of High-Grade Uterine Adenosarcoma with Sarcomatous Overgrowth

This protocol addresses uterine sarcoma in the specific setting of high-grade uterine adenosarcoma with sarcomatous overgrowth, a subtype managed in line with approaches used for other high-grade uterine sarcomas.

Clinical scenario: High-grade uterine adenosarcoma with sarcomatous overgrowth — including cases where morcellation has occurred. The high-grade component and presence of sarcomatous overgrowth place this subtype within the high-grade uterine sarcoma management framework.

Treatment Approach

Given the poor prognosis of this subtype, post-operative systemic chemotherapy is a key consideration for patients with completely resected disease at certain stages — and may also be relevant following morcellation. The full criteria, sequencing, and regimen are in the structured protocol.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1136/ijgc-2024-005823

High-grade sarcomas should be managed with chemotherapy, similar to the approach in other high-grade uterine sarcomas due to similar efficacy with options including doxorubicin as a single agent or combined with ifosfamide.
Adjuvant chemotherapy can be considered as an option in patients with stage II, III–IV completely resected uterine adenosarcoma due to the poor prognosis (IV, C).
In the case of morcellation of a uterine adenosarcoma with a high-grade component/sarcomatous overgrowth, post-operative chemotherapy could be considered (V, C).

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