Expert consensus
The same principles should be applied for corpus uteri as proposed for
vaginal and cervix uteri RMS. The primary goal is to obtain tissue for
diagnosis by appropriate biopsy. Incisional biopsy via laparotomy should
be performed in case of tumors extending into the abdominal cavity. An
alternative approach is percutaneous sheathed tru-cut biopsy with
gelfoam sealing in selected cases. Primary radical surgery including
hysterectomy or pelvic exenteration is not indicated.
Delayed surgery Expert consensus
Patients in CR after 6 cycles of neoadjuvant chemotherapy do not require
secondary tumor resection, but patients with residual tumors after
induction chemotherapy located at the uterine corpus should undergo
abdominal hysterectomy in order to achieve an R0 resection. Preservation
of the distal vagina and the ovaries is usually possible. Oophorectomy
is only indicated if there is a gross ovarian involvement by the tumor.
Placement of abdominal drains should be avoided. Vaginal hysterectomy is
not recommended due to limited intraoperative visualization. RT after
hysterectomy is indicated for patients with positive margins after
surgery.