Evidence:
The analysis of the IRS-I to -IV trials showed a trend towards less
aggressive surgical approaches from pelvic exenteration in IRS-I towards
preservation of a functional genitourinary tract. Therefore, surgical
guidelines tended to delay radical surgery in order to avoid it whenever
possible. However, in cases in which intensive chemotherapy with or
without RT could not eradicate the tumor, radical surgery was
used.9 In the pooled international analysis definitive
local control was achieved in 70% of uterus RMS, and 7 of 12 patients
had hysterectomy as primary surgery.4