A clinicopathologic review and obstetric outcome of uterine smooth muscle tumor of uncertain malignant potential (STUMP) in a single institution

Ha, Hyeong In; Choi, Min Chul; Heo, Jin Hyung; Kim, Kyoung Ah; Jung, Sang Geun; Park, Hyun; Joo, Won Duk; Song, Seung Hun; Kim, Tae Hoen; Lee, Chan

doi:10.1016/j.ejogrb.2018.06.003

Cited by 36 publications

(31 citation statements)

References 14 publications

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“…All of these patients underwent a cesarean section to reduce the risk of uterine rupture with vaginal delivery after myomectomy. Similarly, previously reported patients with successful childbirth after myomectomy were young, and most of them had cesarean sections (14).…”

Section: Discussionmentioning

confidence: 56%

“…For patients with fertility desire, myomectomy should be considered as the first-line treatment (13). There are several reported cases of successful pregnancy after myomectomy for STUMP (14). In this study, 35 patients who underwent myomectomy and were ≤45 years old attempted to conceive during the follow-up period, and 7 (20.0%) succeeded in achieving seven singleton pregnancies.…”

Section: Discussionmentioning

confidence: 76%

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Oncologic and Reproductive Outcomes of Uterine Smooth Muscle Tumor of Uncertain Malignant Potential: A Single Center Retrospective Study of 67 Cases

Huo

Wang

et al. 2020

Front. Oncol.

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Background: The term "uterine smooth muscle tumor of uncertain malignant potential" (STUMP) indicates a rare tumor that cannot be classified as a benign leiomyoma or malignant leiomyosarcoma. In this study, we assessed the clinical characteristics, fertility, and oncologic outcomes of patients diagnosed as STUMP in 14 years. In addition, we analyzed the risk factors for recurrence in patients with STUMP. Methods: Medical records of STUMP patients at Peking Union Medical College Hospital (PUMCH) between January 2005 and June 2019 were reviewed and analyzed. Disease-free survival, age of diagnosis, tumor size, surgical procedure, pathology and immunohistochemistry, clinical characteristics, recurrence rate, and reproductive outcomes in the follow-up period were assessed. Univariate and multivariate analyses were performed to determine the prognostic factors. Results: The median age was 42 years old (range: 21-63). Total hysterectomy with or without bilateral salpingo-oophorectomy was performed in 29/67 cases (43.3%), and myomectomy was performed in 38/67 cases (56.7%). Ten patients experienced recurrences, and all but two recurrences occurred within 5 years after the initial surgery. Only two of these recurrences were leiomyosarcoma. There were no deaths in the median follow-up period of 48.4 (range 2.6-170.2) months. There were no remarkable differences in location of tumor between the myomectomy and hysterectomy groups, but the patients in the myomectomy group were younger than those in the hysterectomy group. In univariate and multivariate analysis, mitosis on pathology was the only independent risk factor for recurrence. Expression of Ki-67, p53, and p16 was significantly higher in patients with recurrence. Seven of the 35 patients who attempted to conceive had successful pregnancies. Huo et al. Uterine Smooth Muscle Tumor Outcomes Conclusions: The prognosis of STUMP was favorable and tumors with more than 10 mitoses per 10 high power field should be monitored closely. The surgical procedure was not an independent risk factor of recurrence, and myomectomy may be an acceptable option for patients wishing to preserve fertility.

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 76%

Oncologic and Reproductive Outcomes of Uterine Smooth Muscle Tumor of Uncertain Malignant Potential: A Single Center Retrospective Study of 67 Cases

Huo

Wang

et al. 2020

Front. Oncol.

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“…Therefore, the major strength of our study is that we presented our data about the results of fertility-sparing approaches. To the best of our knowledge, there are few case reports and case series about fertility desire in patients with STUMPs in the literature [2325262728]. In a single-center study including 19 patients, Ha et al [27] reported recurrence in 2 (10.5%) patients during a 47-month follow-up period.…”

Section: Discussionmentioning

confidence: 99%

Uterine smooth muscle tumor of uncertain malignant potential: fertility and clinical outcomes

et al. 2019

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Objective In this study, we aimed to evaluate the clinicopathological features, obstetric, and oncological outcomes of patients diagnosed with a uterine smooth muscle tumors of uncertain malignant potential (STUMP). Methods A dual-institutional, database review was carried out to screen patients with STUMP who were treated with upfront surgery between January 2006 and December 2017. Data including age at the time of diagnosis, recurrence rate, disease-free survival, overall survival, and fertility outcomes were retrospectively analyzed. Results Fifty-seven patients with STUMPs were included in the study. The median age at the time of diagnosis was 42 (range, 16 to 75) years. The median follow-up was 57 (range, 16 to 125) months. Eight patients (14%) had recurrence during follow-up. Recurrent STUMPs were seen in seven patients and leiomyosarcoma after 14 months in one patient. Seven patients with a recurrent STUMP survived, while the remaining patient died. Recurrence rates were similar for women who underwent myomectomy and those who underwent hysterectomy. The presence of uterine localization of tumor (subserosal vs intramural-submucosal) statistically significantly affected recurrence rates (odds ratio=5.72; 95% confidence interval=1.349–24.290; p=0.018). Ten of 27 patients who underwent myomectomy for uterine myoma had fertility desire. Seven pregnancies were recorded. Conclusions Our study results suggest that fertility-sparing approaches are feasible in patients with STUMP, although recurrence may be seen.

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“… Reference Histologic feature Age Mass size (cm) Surgery Cellularity Atypia MI Necrosis Subtype Recurrence Treatment Outcome H. Sahin et al ( Şahin et al, ) 52 20 Myomectomy high mild 6 present SMT-LMP LMS Debulking + CTx DOD H.I. Ha et al ( Ha et al, 2018 ) 49 6 Hysterectomy high mild 0–3 absent N/A LMS Debulking + CTx N/A Ip PP et al ( Ip et al, 2009 ) 50 5 Hysterectomy moderate severe 4 infarct AL-LE LMS Debulking + CTx AAR Ip PP et al ( Ip et al, 2009 ) 39 5.8 Hysterectomy high severe 5 infarct AL-LE LMS Debulking + CTx AAR Basaran et al ( Basaran et al, 2018 ) 52 N/A Hysterectomy mild mild 2–5 present SMT-LMP LMS Debulking + CTx DOD Basaran et al ( Basaran et al, 2018 ) 51 9 Hysterectomy mild mild < 2 present SMT-LMP LMS …”

Section: Discussionmentioning

confidence: 99%

Giant uterine mass with uterine smooth muscle tumor of uncertain malignant potential: A case report

Jang

Kwon

Cho

et al. 2020

Gynecologic Oncology Reports

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A clinicopathologic review and obstetric outcome of uterine smooth muscle tumor of uncertain malignant potential (STUMP) in a single institution

Cited by 36 publications

References 14 publications

Oncologic and Reproductive Outcomes of Uterine Smooth Muscle Tumor of Uncertain Malignant Potential: A Single Center Retrospective Study of 67 Cases

Oncologic and Reproductive Outcomes of Uterine Smooth Muscle Tumor of Uncertain Malignant Potential: A Single Center Retrospective Study of 67 Cases

Uterine smooth muscle tumor of uncertain malignant potential: fertility and clinical outcomes

Giant uterine mass with uterine smooth muscle tumor of uncertain malignant potential: A case report

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