{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:25:32Z","timestamp":1787750732425,"version":"build-2784847793"},"reference-count":48,"publisher":"Elsevier BV","issue":"4","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,2,9]],"date-time":"2025-02-09T00:00:00Z","timestamp":1739059200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000921","name":"European Cooperation in Science and Technology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000921","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","ejso.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Surgical Oncology"],"published-print":{"date-parts":[[2025,4]]},"DOI":"10.1016\/j.ejso.2025.109646","type":"journal-article","created":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T19:09:15Z","timestamp":1738091355000},"page":"109646","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":7,"title":["Advancements in uterine sarcoma management: A review"],"prefix":"10.1016","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-7037-1283","authenticated-orcid":false,"given":"Vojka","family":"Lebar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0534-704X","authenticated-orcid":false,"given":"Aleksandar","family":"\u010celebi\u0107","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6369-0297","authenticated-orcid":false,"given":"Jean","family":"Calleja-Agius","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0483-9781","authenticated-orcid":false,"given":"Marina","family":"Jakimovska Stefanovska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5548-4116","authenticated-orcid":false,"given":"Kristina","family":"Drusany Staric","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ejso.2025.109646_bib1","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1002\/ijgo.12613","article-title":"Uterine sarcomas","volume":"143","author":"Mbatani","year":"2018","journal-title":"Int J Gynecol Obstet"},{"key":"10.1016\/j.ejso.2025.109646_bib2","series-title":"Female Genital Tumours","year":"2020"},{"key":"10.1016\/j.ejso.2025.109646_bib3","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.ijgo.2008.12.008","article-title":"FIGO staging for uterine sarcomas","volume":"104","author":"Prat","year":"2009","journal-title":"Int. J. Gynaecol. Obstet. Off. Organ Int. Fed. Gynaecol. Obstet."},{"key":"10.1016\/j.ejso.2025.109646_bib4","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1002\/uog.20270","article-title":"Imaging in gynecological disease (15): clinical and ultrasound characteristics of uterine sarcoma","volume":"54","author":"Ludovisi","year":"2019","journal-title":"Ultrasound Obstet Gynecol"},{"key":"10.1016\/j.ejso.2025.109646_bib5","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1007\/s11547-023-01654-1","article-title":"Uterine mesenchymal tumors: development and preliminary results of a magnetic resonance imaging (MRI) diagnostic algorithm","volume":"128","author":"Rosa","year":"2023","journal-title":"Radiol Med"},{"key":"10.1016\/j.ejso.2025.109646_bib6","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1148\/radiol.2020191658","article-title":"Diagnostic algorithm to differentiate benign atypical leiomyomas from malignant uterine sarcomas with diffusion-weighted MRI","volume":"297","author":"Abdel Wahab","year":"2020","journal-title":"Radiology"},{"key":"10.1016\/j.ejso.2025.109646_bib7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41598-022-23064-5","article-title":"Development of a deep learning method for improving diagnostic accuracy for uterine sarcoma cases","volume":"12","author":"Toyohara","year":"2022","journal-title":"Sci Rep"},{"key":"10.1016\/j.ejso.2025.109646_bib8","article-title":"The automatic diagnosis artificial intelligence system for preoperative magnetic resonance imaging of uterine sarcoma","volume":"35","author":"Toyohara","year":"2023","journal-title":"J. Gynecol. Oncol."},{"key":"10.1016\/j.ejso.2025.109646_bib9","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1016\/j.ygyno.2021.04.004","article-title":"Using rADioMIcs and machine learning with ultrasonography for the differential diagnosis of myometRiAL tumors (the ADMIRAL pilot study). Radiomics and differential diagnosis of myometrial tumors","volume":"161","author":"Chiappa","year":"2021","journal-title":"Gynecol Oncol"},{"key":"10.1016\/j.ejso.2025.109646_bib10","article-title":"Drawbacks of artificial intelligence and their potential solutions in the healthcare sector","volume":"1","author":"Khan","year":"2023","journal-title":"Biomed. Mater. Devices N. Y. N"},{"key":"10.1016\/j.ejso.2025.109646_bib11","doi-asserted-by":"crossref","first-page":"2101","DOI":"10.1002\/cncr.35307","article-title":"Uses and limitations of artificial intelligence for oncology","volume":"130","author":"Kolla","year":"2024","journal-title":"Cancer"},{"key":"10.1016\/j.ejso.2025.109646_bib12","series-title":"StatPearls","article-title":"Biochemistry, lactate dehydrogenase","author":"Farhana","year":"2024"},{"key":"10.1016\/j.ejso.2025.109646_bib13","article-title":"Expression and prognostic value of lactate dehydrogenase-A and -D subunits in human uterine myoma and uterine sarcoma","volume":"97","author":"Song","year":"2018","journal-title":"Medicine (Baltim)"},{"key":"10.1016\/j.ejso.2025.109646_bib14","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1186\/s12885-020-07003-z","article-title":"Preoperative clinical characteristics scoring system for differentiating uterine leiomyosarcoma from fibroid","volume":"20","author":"Zhang","year":"2020","journal-title":"BMC Cancer"},{"key":"10.1016\/j.ejso.2025.109646_bib15","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1136\/ijgc-00009577-200207000-00005","article-title":"Usefulness of Gd-DTPA contrast-enhanced dynamic MRI and serum determination of LDH and its isozymes in the differential diagnosis of leiomyosarcoma from degenerated leiomyoma of the uterus","volume":"12","author":"Goto","year":"2002","journal-title":"Int. J. Gynecol. Cancer Off. J. Int. Gynecol. Cancer Soc"},{"key":"10.1016\/j.ejso.2025.109646_bib16","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1186\/s12905-018-0662-5","article-title":"Increased LDH5\/LDH1 ratio in preoperative diagnosis of uterine sarcoma with inconclusive MRI and LDH total activity but suggestive CT scan: a case report","volume":"18","author":"Mollo","year":"2018","journal-title":"BMC Wom Health"},{"key":"10.1016\/j.ejso.2025.109646_bib17","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.ejogrb.2019.03.017","article-title":"A more accurate method to interpret lactate dehydrogenase (LDH) isoenzymes' results in patients with uterine masses","volume":"236","author":"Di Cello","year":"2019","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"10.1016\/j.ejso.2025.109646_bib18","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/j.fertnstert.2020.07.020","article-title":"Specificity of the lactate dehydrogenase isoenzyme index as a preoperative screen for uterine sarcoma before myomectomy","volume":"115","author":"Spivack","year":"2021","journal-title":"Fertil Steril"},{"key":"10.1016\/j.ejso.2025.109646_bib19","first-page":"1069","article-title":"Use of 18F-fluorodeoxyglucose positron emission tomography for diagnosis of uterine sarcomas","volume":"23","author":"Nagamatsu","year":"2010","journal-title":"Oncol Rep"},{"key":"10.1016\/j.ejso.2025.109646_bib20","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1016\/j.tjog.2017.05.003","article-title":"Efficacy of PET\/CT to exclude leiomyoma in patients with lesions suspicious for uterine sarcoma on MRI","volume":"56","author":"Kusunoki","year":"2017","journal-title":"Taiwan J Obstet Gynecol"},{"key":"10.1016\/j.ejso.2025.109646_bib21","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1016\/j.ejso.2010.05.004","article-title":"Neutrophil to lymphocyte ratio for preoperative diagnosis of uterine sarcomas: a case-matched comparison","volume":"36","author":"Kim","year":"2010","journal-title":"Eur. J. Surg. Oncol. EJSO"},{"key":"10.1016\/j.ejso.2025.109646_bib22","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1111\/jog.12915","article-title":"Differential diagnosis between uterine sarcoma and leiomyoma using preoperative clinical characteristics","volume":"42","author":"Cho","year":"2016","journal-title":"J Obstet Gynaecol Res"},{"key":"10.1016\/j.ejso.2025.109646_bib23","doi-asserted-by":"crossref","DOI":"10.1097\/IGC.0000000000000037","article-title":"Growth differentiation factor-15 as biomarker in uterine sarcomas","volume":"24","author":"Trovik","year":"2014","journal-title":"Int J Gynecol Cancer"},{"key":"10.1016\/j.ejso.2025.109646_bib24","doi-asserted-by":"crossref","first-page":"3718","DOI":"10.1111\/cas.14215","article-title":"Serum microRNA profile enables preoperative diagnosis of uterine leiomyosarcoma","volume":"110","author":"Yokoi","year":"2019","journal-title":"Cancer Sci"},{"key":"10.1016\/j.ejso.2025.109646_bib25","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1007\/s11912-020-0864-5","article-title":"Circulating transcripts and biomarkers in uterine tumors: is there a predictive role?","volume":"22","author":"De Bruyn","year":"2020","journal-title":"Curr Oncol Rep"},{"key":"10.1016\/j.ejso.2025.109646_bib26","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1111\/jog.13792","article-title":"Diagnostic value of combination serum assay of lactate dehydrogenase, D-dimer, and C-reactive protein for uterine leiomyosarcoma","volume":"45","author":"Nishigaya","year":"2019","journal-title":"J Obstet Gynaecol Res"},{"key":"10.1016\/j.ejso.2025.109646_bib27","doi-asserted-by":"crossref","DOI":"10.3802\/jgo.2017.28.e46","article-title":"Safety of ovarian preservation in premenopausal women with stage I uterine sarcoma","volume":"28","author":"Nasioudis","year":"2017","journal-title":"J. Gynecol. Oncol."},{"key":"10.1016\/j.ejso.2025.109646_bib28","doi-asserted-by":"crossref","first-page":"1140","DOI":"10.3390\/medicina58091140","article-title":"Is adnexectomy mandatory at the time of hysterectomy for uterine sarcomas? A systematic review and meta-analysis","volume":"58","author":"Ronsini","year":"2022","journal-title":"Medicina (Mex.)"},{"key":"10.1016\/j.ejso.2025.109646_bib29","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.ejogrb.2022.10.013","article-title":"Prognostic significance of lymphadenectomy in uterine leiomyosarcomas and endometrial stromal sarcomas: systematic review and meta-analysis","volume":"279","author":"Li","year":"2022","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"10.1016\/j.ejso.2025.109646_bib30","doi-asserted-by":"crossref","DOI":"10.1016\/j.suronc.2021.101589","article-title":"Role of lymphadenectomy for apparent early stage uterine sarcoma; a comprehensive analysis of the national cancer database","volume":"38","author":"Nasioudis","year":"2021","journal-title":"Surg. Oncol"},{"key":"10.1016\/j.ejso.2025.109646_bib31","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.ygyno.2017.02.012","article-title":"Prognosis and treatment of uterine leiomyosarcoma: a national cancer database study","volume":"145","author":"Seagle","year":"2017","journal-title":"Gynecol Oncol"},{"key":"10.1016\/j.ejso.2025.109646_bib32","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1111\/IGC.0b013e3181b33c9a","article-title":"Does radiotherapy or lymphadenectomy improve survival in endometrial stromal sarcoma?","volume":"19","author":"Barney","year":"2009","journal-title":"Int. J. Gynecol. Cancer Off. J. Int. Gynecol. Cancer Soc."},{"key":"10.1016\/j.ejso.2025.109646_bib33","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1097\/IGC.0000000000000842","article-title":"Role of lymphadenectomy for uterine sarcoma: a meta-analysis","volume":"27","author":"Si","year":"2017","journal-title":"Int. J. Gynecol. Cancer Off. J. Int. Gynecol. Cancer Soc."},{"key":"10.1016\/j.ejso.2025.109646_bib34","doi-asserted-by":"crossref","first-page":"921","DOI":"10.3390\/cancers14040921","article-title":"New insights into hormonal therapies in uterine sarcomas","volume":"14","author":"Maccaroni","year":"2022","journal-title":"Cancers"},{"key":"10.1016\/j.ejso.2025.109646_bib35","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.ejca.2020.08.016","article-title":"Italian consensus conference on management of uterine sarcomas on behalf of S.I.G.O. (Societa\u2019 italiana di ginecologia E ostetricia)","volume":"139","author":"Ferrandina","year":"2020","journal-title":"Eur J Cancer"},{"key":"10.1016\/j.ejso.2025.109646_bib36","doi-asserted-by":"crossref","first-page":"1499","DOI":"10.1136\/ijgc-2024-005823","article-title":"ESGO\/EURACAN\/GCIG guidelines for the management of patients with uterine sarcomas","volume":"34","author":"Ray-Coquard","year":"2024","journal-title":"Int J Gynecol Cancer"},{"key":"10.1016\/j.ejso.2025.109646_bib37","doi-asserted-by":"crossref","first-page":"4761","DOI":"10.3390\/jcm11164761","article-title":"Fertility-sparing management may Be considered in young women with uterine sarcoma","volume":"11","author":"Pi\u0105tek","year":"2022","journal-title":"J Clin Med"},{"key":"10.1016\/j.ejso.2025.109646_bib38","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1006\/gyno.1998.5124","article-title":"Fertility-sparing surgery in uterine leiomyosarcoma","volume":"70","author":"Lissoni","year":"1998","journal-title":"Gynecol Oncol"},{"key":"10.1016\/j.ejso.2025.109646_bib39","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/j.ygyno.2014.11.011","article-title":"Impact of morcellation on survival outcomes of patients with unexpected uterine leiomyosarcoma: a systematic review and meta-analysis","volume":"137","author":"Bogani","year":"2015","journal-title":"Gynecol Oncol"},{"key":"10.1016\/j.ejso.2025.109646_bib40","doi-asserted-by":"crossref","DOI":"10.1097\/IGC.0000000000000911","article-title":"European society of gynecological oncology statement on fibroid and uterine morcellation","volume":"27","author":"Halaska","year":"2017","journal-title":"Int J Gynecol Cancer"},{"key":"10.1016\/j.ejso.2025.109646_bib41","series-title":"Perform only contained morcellation when laparoscopic power morcellation is appropriate: FDA safety communication","author":"Health","year":"2020"},{"key":"10.1016\/j.ejso.2025.109646_bib42","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.ijsu.2018.12.013","article-title":"Feasibility of myomatous tissue extraction in laparoscopic surgery by contained in \u2013 bag morcellation: a retrospective single arm study","volume":"62","author":"Devassy","year":"2019","journal-title":"Int J Surg"},{"key":"10.1016\/j.ejso.2025.109646_bib43","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1080\/13645706.2021.1982727","article-title":"Endobag use in laparoscopic gynecological surgeries: a systematic review","volume":"31","author":"Feghali","year":"2022","journal-title":"Minim Invasive Ther Allied Technol"},{"key":"10.1016\/j.ejso.2025.109646_bib44","doi-asserted-by":"crossref","first-page":"3412","DOI":"10.1200\/JCO.19.00562","article-title":"Association between power morcellation and mortality in women with unexpected uterine cancer undergoing hysterectomy or myomectomy","volume":"37","author":"Xu","year":"2019","journal-title":"J Clin Oncol"},{"key":"10.1016\/j.ejso.2025.109646_bib45","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.ygyno.2020.10.020","article-title":"The impact of tumor fragmentation in patients with stage I uterine leiomyosarcoma on patterns of recurrence and oncologic outcome","volume":"160","author":"Pedra Nobre","year":"2021","journal-title":"Gynecol Oncol"},{"key":"10.1016\/j.ejso.2025.109646_bib46","first-page":"8136","article-title":"Uterine smooth muscle tumors of uncertain malignant potential (STUMP): pathology, follow-up and recurrence","volume":"7","author":"Dall'Asta","year":"2014","journal-title":"Int J Clin Exp Pathol"},{"key":"10.1016\/j.ejso.2025.109646_bib47","doi-asserted-by":"crossref","first-page":"2323","DOI":"10.3390\/cancers14092323","article-title":"Recurrence of uterine smooth muscle tumor of uncertain malignant potential: a systematic review of the literature","volume":"14","author":"Di Giuseppe","year":"2022","journal-title":"Cancers"},{"key":"10.1016\/j.ejso.2025.109646_bib48","doi-asserted-by":"crossref","first-page":"522","DOI":"10.5468\/ogs.22236","article-title":"Laparoscopic systemic restaging surgery for women with unexpected uterine malignancy","volume":"65","author":"Kim","year":"2022","journal-title":"Obstet. Gynecol. Sci."}],"container-title":["European Journal of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0748798325000745?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0748798325000745?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T08:11:40Z","timestamp":1774858300000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0748798325000745"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":48,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["S0748798325000745"],"URL":"https:\/\/doi.org\/10.1016\/j.ejso.2025.109646","relation":{},"ISSN":["0748-7983"],"issn-type":[{"value":"0748-7983","type":"print"}],"subject":[],"published":{"date-parts":[[2025,4]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Advancements in uterine sarcoma management: A review","name":"articletitle","label":"Article Title"},{"value":"European Journal of Surgical Oncology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ejso.2025.109646","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 The Authors. Published by Elsevier Ltd.","name":"copyright","label":"Copyright"}],"article-number":"109646"}}