The following article is based upon the personal research of the author, a lay person. It should be used only as a general guidance in interacting with your doctors, and should not be considered a substitute for expert medical opinion. 

This article defines adjuvant [or adjunctive] treatment as the administration of chemotherapy or radiation following surgical removal of the primary tumor with wide margins, when no secondaries are known to exist. Although there is some evidence that adjuvant treatment is useful for some soft tissue sarcomas, there is no hard evidence that it either prevents recurrence or prolongs survival for Leiomyosarcoma patients. 

This section is meant to assist those who are faced with the question of whether to undergo adjuvant treatment after surgery. 

<b>There is Time To Decide:</b> No matter what pre-surgical opinions one may have, there is no need to make a decision about adjuvant treatment before surgery. There will also be enough time after surgery to discuss the pros and cons. Even if the decision were to proceed with further treatment, most surgeons and oncologists would agree upon a significant recovery period (at least one month) following surgery before starting adjuvant treatment. 

<b>How to Make the Decision:</b> After surgery ask for a copy of the <b>operative report</b> prepared by the surgeon (all surgeons prepare such a report). Read it carefully to determine whether the surgeon felt he/she had achieved clear margins and how large those margins were. 

After reading the report, discuss it with your surgeon on your first postoperative visit. Make sure you understand what occurred with regard to margins. You may also want to ask the surgeon how successful he/she thought the surgery was with regard to eliminating the Leiomyosarcoma tumor(s). You may also want to explore whether there was any spillage while excising the tumor(s), although there is some disagreement over whether this factor influences future recurrences. 

You should also ask for copies of any <b>pathology reports</b>. Do they offer any information about the virulence of your tumor(s)? Did they test your tumors for c-kit? If they did not test your tumors for c-kit, ask them to do so (although it is unlikely that Leiomyosarcoma originating outside of the abdominal cavity would be c-kit positive, ask for the test to be done anyway just in case--the results are critical to future decision making). 

<b>The next person you should see after your surgeon is a sarcoma specialist, at least for a consult</b>. You should bring your operative and pathology reports with you. 

Should you be c-kit positive, you may be eligible for treatment with a new drug called STI-571. People who are c-kit positive should be particularly cautious about adjuvant therapies, as there may be a much better alternative. 

<b>Let's turn to the pros and cons of adjuvant treatment:</b>