Uterine sarcoma is a cancer of the muscle and supporting tissues of the uterus (womb).

Sarcomas are cancers that start from tissues such as muscle, fat, bone, and fibrous tissue. Cancers that start in epithelial cells, the cells that line or cover most organs, are called carcinomas.

More than 95% of cancers of the uterus are carcinomas. If a carcinoma starts in the cervix, it is called a cervical carcinoma. Carcinomas starting in the endometrium, the lining of the uterus, are called endometrial carcinomas. These 2 cancers are discussed in separate documents available from the American Cancer Society. This document is about uterine sarcomas.

Most uterine sarcomas fall into 1 of 2 categories, based on the type of cell they developed from:

• Endometrial stromal sarcomas develop in the supporting connective tissue (stroma) of the endometrium. These cancers are rare, representing a little over 1% of all uterine cancers. These tumors can be divided into 2 groups: low-grade and undifferentiated (high-grade). Low-grade endometrial stromal sarcomas tend to grow slowly - patients with these tumors have a better outlook than those with undifferentiated tumors.
• Uterine leiomyosarcomas start in the muscular wall of the uterus known as the myometrium. These tumors make up about 2% of cancers that start in the uterus.

Another type of cancer that starts in the uterus is called carcinosarcoma. These cancers start in the endometrium and have features of both sarcomas and carcinomas. They can be classified with uterine sarcomas, but many doctors believe they are more closely related to carcinomas. These cancers are also known as malignant mixed mesodermal tumors or malignant mixed mullerian tumors.

The 4 basic types of treatment for women with uterine sarcoma are surgery, radiation therapy, chemotherapy, and hormone therapy. A combination of these treatments may be used. Which treatment(s) are used depends on the type and stage of your cancer as well as your overall medical condition. Most women with uterine sarcoma have surgery to remove the cancer. Radiation, chemo, and hormonal therapy are sometimes given to lower the risk of the cancer coming back after surgery.

• Surgery is the primary (main) treatment for uterine sarcoma. The major goal of surgery is to remove all of the cancer. This usually means removing the uterus, but for some tumors, the fallopian tubes, ovaries, and part of the vagina may also need to be removed. Some lymph nodes or other tissue may be taken out as well to see if the cancer has spread outside the uterus.
• Radiation therapy uses high-energy radiation (such as x-rays) to kill cancer cells. These treatments may be given externally in a procedure that is much like having a diagnostic x-ray. This is called external beam radiation therapy.
• Radiation therapy also may be given by placing radioactive materials near the tumor. This is called brachytherapy. Women treated with this type of radiation do not remain radioactive after the implant is removed. In some situations, both brachytherapy and external beam radiation therapy are given.
• Chemotherapy is the use of drugs to treat cancer. The drugs can be swallowed in pill form, or they can be injected by needle into a vein or muscle. Chemotherapy is considered systemic therapy. This means that the drug enters the bloodstream and circulates throughout the body to reach and destroy cancer cells - making this treatment useful for cancer that has spread beyond the uterus.
• Hormone therapy is the use of hormones or hormone-blocking drugs to fight cancer. It is mainly used to treat patients with endometrial stromal sarcomas and is rarely used for the other type of uterine sarcoma.

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