New Aspects of Sarcomas of Uterine Corpus—A Brief Narrative Review

Round 1

Reviewer 1 Report

the paper is a complete review of rare gynecological cancers for which
there are still few data in the literature on both aetiology, diagnosis
and treatment. In the manuscript all aspects are examined and I believe that
its reading is a valid incentive for all readers to hypothesize even in the
most common cases of metrorrhagia or other more common symptoms of this
pathology.

Author Response

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Reviewer 2 Report

The authors attempted to review the new aspects of uterine sarcomas. This manuscript is of some interest; however, this manuscript is superficial and the authors failed to cite the key studies of each topic. The reviewer’s comments are listed below.

 

I recommend that the manuscript be reviewed by a person with professional proficiency in English to correct errors in grammar, punctuation, word choice, and sentence construction to improve the flow of ideas expressed in the article to ensure that the document reads as though written by a native English speaker.

 

Please not change the aspect ratio of images.

Please do not use abbreviations without the definition.

 

The authors may delete the following sentences:

Juang et al. analyzed 42 cases of uterine leiomyosarcoma and 84 cases of uterine leiomyoma. The authors’ findings demonstrated that preoperative serum CA125 levels were

significantly higher in the uterine leiomyosarcoma group than in the uterine leiomyoma

group [19].

 

Imaging modalities

This section is recommended to be revised adding the following important points. Leiomyomas and uterine sarcomas appear similar on imaging; both are focal masses within the uterus, and both can have central necrosis. Therefore, there is no pelvic imaging modality that can reliably diagnose uterine sarcomas, and because of the low prevalence of sarcomas, it is unlikely that any single test will have a high positive predictive value for sarcoma. Despite these limitations, the reviewer suggests that patients with a newly diagnosed or markedly enlarging pelvic mass undergo a pelvic ultrasound as an initial imaging study.

 

Prognostic factor

Please cite this study (Int J Gynecol Cancer. 2016;26(6):1098.) and please remove the retrospective studies with a small number size.

 

The description of surgical treatment and adjuvant therapy is superficial and should be revised. A prospective, randomized trial was conducted by the Gynecologic Oncology Group (GOG) in collaboration with the European Organisation for Research and Treatment of Cancer (EORTC) and Cancer Research UK, which compared the regimen from SARC 005 with observation in women who had undergone surgical resection of high-grade International Federation of Gynecology and Obstetrics (FIGO) stage I uterine LMS (GOG 277) (J Clin Oncol. 2018 Oct 5;36(33): JCO1800454.). The authors may cite this study.

 

The authors should add the treatment for recurrent or metastatic leiomyosarcoma.

Author Response

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Reviewer 3 Report

I congratulate you on the excellent work done by the authors, who have dealt with the delicate, long and complex topic with mastery of the topic and synthesis. Obviously, a chapter would not be enough to fully discuss the subject, but the authors have done their discursive work very well.
I suggest changing the title: a brief literature review
in: a brief narrative review.
In my opinion, it is not useful to insert images of surgical pieces (of little significance for readers), on the contrary it would be useful to insert diagnostic histological or radiological images, very useful to the gynecological community.
It would then be useful to insert, if possible, therapeutic flowcharts for the types treated (even a single flowchart that summarizes everything).

Author Response

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Author Response File: Author Response.docx