<b>Adjuvant Treatment.</b> Treatment when all disease has been removed and the patient is in remission. It is done in the hope that the chemotherapy will have some quelling action on unseen microscopic deposits.   HOWEVER: There is no way to tell if this indeed is happening, because there is no "evaluable" disease...there are no tumors visible that can be seen to be shrinking. And LMS is notoriously resistant to chemotherapy. So one could be using up a chemotherapy choice [LMS gets resistant to chemo agents], or bone marrow reserve, for a non-life threatening situation.  One could also be getting extra months of toxic treatment with no benefit. The role of adjuvant treatment in LMS is not simple.  There are some situations in which it gives a clear increase in survival time, others in which there is no proven benefit.   This should be discussed thoroughly with a SARCOMA oncologist, and the relevant medical research discussed.  Make sure that the studies are discussing your particular leiomyosarcoma primary site, not leiomyosarcomas or sarcomas in general.  Some sarcomas are relatively radiation and chemotherapy sensitive, and research including these tumors is not relevant to LMS.

<b>Positive Margins.</b> Surgical margins were narrow, or not clear of tumor.  In some situations where tumor cells were left behind, chemotherapy or radiation has been shown to give a clear survival benefit.

<b>NeoAdjuvant Treatment.</b> Treatment to shrink inoperable tumors so that they are operable.   If the disease is inoperable, it is possible that chemotherapy will shrink the tumor so that it becomes operable, or capable of being ablated [destroyed] by RFA or cryosurgery [see Metastatic Disease page.]   This is sometimes called "downstaging" the disease.

<b>Treatment before and after surgery.</b> If a chemotherapy agent is used that the tumor responds to, and then the tumor is resected with clear margins, and then that same chemotherapy agent is continued after surgery, there might be a longer disease free interval.

<b>Control of Systemic Disease.</b> If multiple metastases or cascades occur, systemic chemotherapy might be able to control the disease and even eradicate metastases, before they become overwhelming.

<b>Palliation.</b> When the tumors are inoperable, chemotherapy is used to buy time, or decrease pain or discomfort. It is possible that a LOT of time can be bought. This depends upon the sensitivity of the tumor to the chemotherapy.  In this situation, there is no advantage to using polychemotherapy; so individual chemotherapy agents are used until resistance develops, sequentially.