The surgical intervention

Sarcomas are generally aggressive tumors with a high rate of recurrence. The consensual treatment of sarcoma is surgery, the objective of which is the complete removal of the tumor, without fragmentation. For uterine sarcomas, the uterus and ovaries must be removed. Dissection (removal of lymph nodes) is not necessary in uterine sarcomas.

The intervention is most often performed by laparotomy (classic opening of the belly). It is indeed essential not to fragment the tumor during its extraction. The operative technique must be adapted, hence the importance of having suspected the diagnosis before the operation. Only small-volume uterine sarcomas, not requiring morcellation, can be operated on by laparoscopy.

If the tumor is extended outside the uterus, heavier interventions involving digestive resections, bladder, etc. can also be offered.
Post-operative monitoring in a continuous care unit for 24 to 72 hours is sometimes necessary depending on the type of surgery (extensive resection or significant blood loss).
The complications of this type of intervention are mainly bleeding, but also digestive or urinary complications as well as phlebitis / pulmonary embolism (complications of major interventions).

It is important that the team caring for the patient is familiar with this pathology (both for reading or rereading the imaging, and for surgery or histological analysis of the tumour). Rereading of the slides must be systematic within an expert center of the sarcoma reference network. A network exists in France, which identifies the sites recommended for the treatment of sarcomas. (the list of specialized centers is given on the site www.netsarc.sarcomabcb.org; Institut Curie, labeled European expert center is one of them: Dr S Bonvalot, www.curie.fr)