Evidence map›Paper›PMID 42449606›Full record

ReviewCancers2026

Extended and Repeated Cytoreductive Surgery in Recurrent Uterine Leiomyosarcoma: A Narrative Review.

Antonio Maccio, Manuela Neri, Valerio Vallerino, Sonia Nemolato, Elisabetta Pusceddu, Gabriele Sole, Paolo Albino Ferrari

Abstract readReview
In one paragraph

Review in Cancers, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Antonio MaccioDepartment of Obstetrics and Gynecology and Gynecological Oncology, Azienda di Rilievo Nazionale ed Alta Specializzazione "G. Brotzu", Piazza A. Ricchi 1, 09121 Cagliari, Italy.ORCID 0000-0003-0577-7217
Manuela NeriDepartment of Obstetrics and Gynecology and Gynecological Oncology, Azienda di Rilievo Nazionale ed Alta Specializzazione "G. Brotzu", Piazza A. Ricchi 1, 09121 Cagliari, Italy.
Valerio VallerinoDepartment of Obstetrics and Gynecology and Gynecological Oncology, Azienda di Rilievo Nazionale ed Alta Specializzazione "G. Brotzu", Piazza A. Ricchi 1, 09121 Cagliari, Italy.
Sonia NemolatoUnit of Anatomic Pathology, Azienda di Rilievo Nazionale ed Alta Specializzazione "G. Brotzu", Piazza A. Ricchi 1, 09121 Cagliari, Italy.ORCID 0009-0001-6895-042X
Elisabetta PuscedduAnesthesia and Intensive Care Unit, Liver Transplantation Center, Azienda di Rilievo Nazionale ed Alta Specializzazione "G. Brotzu", Piazza A. Ricchi 1, 09121 Cagliari, Italy.ORCID 0009-0004-1319-6556
Gabriele SoleDepartment of Oncological Surgery, Azienda di Rilievo Nazionale ed Alta Specializzazione "G. Brotzu", Piazza A. Ricchi 1, 09121 Cagliari, Italy.ORCID 0000-0001-5387-4068
Paolo Albino FerrariDepartment of Oncological Surgery, Azienda di Rilievo Nazionale ed Alta Specializzazione "G. Brotzu", Piazza A. Ricchi 1, 09121 Cagliari, Italy.ORCID 0000-0002-1788-5322

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

objectivesRecurrent uterine leiomyosarcoma (ULMS) frequently poses a surgical question because systemic options remain limited and recurrence patterns are heterogeneous. We reviewed the published evidence on repeated and extended cytoreductive surgery for recurrent ULMS, focusing on selection criteria, operative boundaries, and the role of multivisceral, thoracic, and peritoneal-directed procedures.

methodsThis narrative review synthesizes peer-reviewed literature on surgically managed recurrent or metastatic ULMS, prioritizing contemporary guidelines, retrospective cohorts, pooled analyses, selected systematic reviews when directly relevant to the surgical question, and published illustrative reports. The search covered records available from database inception through 14 May 2026 and used PubMed/MEDLINE, Web of Science Core Collection, Scopus, Google Scholar, selected publisher databases, and citation-linked records. No new patient-level or institution-specific clinical data are presented.

resultsThe available evidence is entirely retrospective and strongly affected by selection bias, yet it consistently suggests that the best outcomes are observed when complete gross resection is feasible. Across published series, favorable features include isolated or limited recurrence, longer time to relapse, compartmentalized disease, lung-only metastases, and preserved performance status. Contemporary reports also show that repeat surgery may evolve into extensive multivisceral procedures involving bowel resection, upper-abdominal dissection, urinary tract reconstruction, diaphragmatic resection, and thoracic surgery. Peritoneal-directed CRS/HIPEC-type strategies remain supported mainly by small heterogeneous studies and a ULMS-specific systematic review, reinforcing feasibility but not routine use. Published illustrative reports confirm that serial metastasectomies can occasionally support prolonged survival in exceptional patients, but they cannot establish effectiveness.

conclusionsIn highly selected patients, repeated and even extensive cytoreductive surgery may remain a rational disease-control strategy for recurrent ULMS. The central unmet need is not proof that surgery can work in exceptional cases, but better criteria to identify who benefits from iterative resection and when escalation to multivisceral or thoracoabdominal surgery is justified.

Indexed as

cytoreductive surgerygynecologic oncologymetastasectomymultivisceral resectionnarrative reviewpulmonary metastasectomyrecurrent diseaseuterine leiomyosarcoma

Identifiers

PMID42449606
PMCPMC13359602

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.