Primary leiomyosarcoma of cervix: now it counts!

Aim of the Study: To review and suggest treatment approach for Primary Leiomyosarcoma of cervix. Material and Method: This literature review has been done to find out optimum management protocol for Primary Leiomyosarcoma of the cervix by search in PubMed Central, Embase, Cochrane, and Web of Science Central database. The obtained information, thus, has been classified as per Oxford Centre for Evidence Based Medicine (OCEBM) level of evidence, and National Comprehensive Cancer Network (NCCN) Categories of Evidence and Consensus. Current treatment scenario for sarcoma and its outcome will be discussed for treatment naive case of primary leiomyosarcoma of cervix based on systematic review, line listing of old reported cases and treatment evidence. Results: Leiomyosarcoma of cervix, though, is rare malignancy, the number is steadily increasing. It generally occurs in the perimenopausal and postmenopausal population, mean age being 46 years. No specific risk factor has been identified so far. Diagnosis is confirmed by histopathology and immunohistochemistry. Prognosis corresponds to stage and grade of disease. Combined modality including surgery, radiotherapy and chemotherapy used in these patients has achieved better survival compared to any single modality. Conclusion: Aggressive approach with combined modality including surgery, radiotherapy and chemotherapy need to be used in these patients to achieve better survival. Though, intensive literature search reveals lack of definitive guidelines for management of leiomyosarcoma of cervix, rising number of cases warrants to frame the guidelines.