A closer look at the natural history and recurrence patterns of high-grade truncal/extremity leiomyosarcomas: A multi-institutional analysis from the US Sarcoma Collaborative

Lee, Rachel; Ethun, Cecilia G.; Zaidi, Mohammad Y.; Tran, Thuy B.; Poultsides, George A.; Grignol, Valerie; Howard, John H.; Bedi, Meena; Gamblin, T. Clark; Tseng, Jennifer F.; Roggin, Kevin K.; Chouliaras, Konstantinos; Votanopoulos, Konstantinos I.; Krasnick, Bradley A.; Fields, Ryan C.; Oskouei, Shervin V.; Monson, David K.; Reimer, Nickolas B.; Maithel, Shishir K.; Cardona, Kenneth

doi:10.1016/j.suronc.2020.06.003

Cited by 4 publications

(7 citation statements)

References 18 publications

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“…show that grade III tumors are signi cantly more likely to metastasize to the lungs compared to low-grade tumors, with an odds ratio of 9.74 (p = 0.046). The 5-year overall survival rate in this cohort was 59%, Lee and colleagues describe and similar average age and tumor size of 63 years and 6.0 cm, respectively [11]. Similarly, Gladdy et al describe a median age of 57 years, and average tumor size of 6.0 cm and identi ed high grade tumors as predictive of disease-speci c survival [10].…”

Section: Discussionsupporting

confidence: 60%

“…Despite the relatively poor prognosis of LMS, one of the more common soft-tissue sarcoma subtypes, there is a paucity of data describing the metastatic pattern, prognostic factors, and e cacy of speci c staging or surveillance imaging modalities [10][11][12][13]. We therefore sought to answer three questions: (1) What is the anatomical distribution and frequency of metastatic disease in truncal/extremity LMS?…”

Section: Discussionmentioning

confidence: 99%

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Metastatic Pattern of Truncal and Extremity Leiomyosarcoma: Retrospective Analysis of Predictors, Outcomes, and Detection

Tigchelaar

Frey

Segovia

et al. 2021

Preprint

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BackgroundLeiomyosarcomas (LMS) are a heterogenous group of malignant mesenchymal neoplasms with smooth muscle origin and are classified as either non-uterine (NULMS) or uterine (ULMS). Metastatic pattern, prognostic factors, and ideal staging/surveillance studies for truncal and extremity LMS have not been defined.MethodsA retrospective analysis of patients diagnosed with histopathology-confirmed truncal or extremity LMS between 2009-2019 was conducted. Data collected included demographics, tumor characteristics, staging, surveillance, and survival endpoints. Primary site was defined as either 1. Extremity, 2. Flank/Pelvis, or 3. Chest wall/Spine.ResultsWe identified 73 patients, 23.3% of which had metastatic LMS at primary diagnosis, while 68.5% developed metastatic disease at any point. The mean metastatic-free survival from primary diagnosis of localized LMS was 3.0±2.8 years. Analysis of prognostic factors revealed that greater age (≥50 years) at initial diagnosis (OR=3.74, p=0.0003) and higher tumor grades II (OR=16, p=0.019) and III (OR=13, p=0.025) were significantly associated with metastases.ConclusionsTruncal and peripheral extremity LMS is an aggressive tumor with high metastatic potential. While there is a significant risk of metastases to lungs, extra-pulmonary tumors are relatively frequent. Older patients and patients with higher-grade (II/III) tumors carry an increased risk of developing metastatic disease.

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Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Metastatic Pattern of Truncal and Extremity Leiomyosarcoma: Retrospective Analysis of Predictors, Outcomes, and Detection

Tigchelaar

Frey

Segovia

et al. 2021

Preprint

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“…Prognostic determinants encompass tumor attributes, disease extent, and patient well-being. However, recent investigations suggest a relatively low incidence of local recurrence (12-15%) coupled with a modest rate of distant metastasis (29-35%), offering a glimmer of hope amidst the prevailing gloom [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

A Giant, Neglected Leiomyosarcoma on the Left Shoulder

Noorali,

Casadesus,

Kaldas

et al. 2024

Cureus

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This paper examines the impact of delayed diagnosis and treatment on the prognosis of patients with leiomyosarcomas (LMS). We present a case study highlighting the consequences of neglected LMS, focusing on vascular involvement and metastatic potential. Our findings underscore the importance of early detection and intervention in improving patient outcomes. Additionally, we discuss the challenges associated with diagnosing rare skin LMS and the implications of limited access to medical screening. Through a comprehensive analysis of the literature, we elucidate the critical role of routine surveillance in detecting these malignancies at an earlier stage, thus facilitating timely intervention and potentially curative treatment. This study underscores the urgency of raising awareness among both healthcare providers and the general population about the significance of early detection and prompt management in mitigating the adverse outcomes associated with neglected LMS.

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“…Despite the relatively poor prognosis of LMS, one of the more common soft-tissue sarcoma subtypes, there is a paucity of data describing the metastatic pattern, prognostic factors, and efficacy of specific staging or surveillance imaging modalities [ 10 , 11 , 12 , 13 ]. We therefore sought to answer three questions: (1) What is the anatomical distribution and frequency of metastatic disease in truncal/extremity LMS?…”

Section: Discussionmentioning

confidence: 99%

“…More recently, Lee et al compared the response to radiation treatment of truncal/extremity LMS versus non-LMS soft-tissue sarcomas. Lee and colleagues describe comparable average age and tumor size of 63 years and 6.0 cm, respectively [ 11 ]. Similarly, Gladdy et al describe a median age of 57 years, an average tumor size of 6.0 cm, and identified high grade tumors as predictive of disease-specific survival [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Metastatic Pattern of Truncal and Extremity Leiomyosarcoma: Retrospective Analysis of Predictors, Outcomes, and Detection

Tigchelaar

Frey

Sivaraj

et al. 2022

JPM

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Leiomyosarcomas (LMS) are a heterogenous group of malignant mesenchymal neoplasms with smooth muscle origin and are classified as either non-uterine (NULMS) or uterine (ULMS). Metastatic pattern, prognostic factors, and ideal staging/surveillance studies for truncal and extremity LMS have not been defined. A retrospective analysis of patients diagnosed with histopathology-confirmed truncal or extremity LMS between 2009 and 2019 was conducted. Data collected included demographics, tumor characteristics, staging, surveillance, and survival endpoints. The primary site was defined as: (1) extremity, (2) flank/Pelvis, or (3) chest wall/Spine. We identified 73 patients, 23.3% of which had metastatic LMS at primary diagnosis, while 68.5% developed metastatic disease at any point. The mean metastatic-free survival from primary diagnosis of localized LMS was 3.0 ± 2.8 years. Analysis of prognostic factors revealed that greater age (≥50 years) at initial diagnosis (OR = 3.74, p = 0.0003), higher tumor differentiation scores (OR = 12.09, p = 0.002), and higher tumor necrosis scores (OR = 3.65, p = 0.026) were significantly associated with metastases. Older patients (≥50 years, OR = 4.76, p = 0.017), patients with larger tumors (≥5 cm or ≥10 cm, OR = 2.12, p = 0.02, OR = 1.92, p = 0.029, respectively), higher differentiation scores (OR = 15.92, p = 0.013), and higher necrosis scores (OR = 4.68, p = 0.044) show worse survival outcomes. Analysis of imaging modality during initial staging and during surveillance showed greater tumor detection frequency when PET imaging was employed, compared to CT imaging (p < 0.0001). In conclusion, truncal and peripheral extremity LMS is an aggressive tumor with high metastatic potential and mortality. While there is a significant risk of metastases to lungs, extra-pulmonary tumors are relatively frequent, and broad surveillance may be warranted.

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A closer look at the natural history and recurrence patterns of high-grade truncal/extremity leiomyosarcomas: A multi-institutional analysis from the US Sarcoma Collaborative

Cited by 4 publications

References 18 publications

Metastatic Pattern of Truncal and Extremity Leiomyosarcoma: Retrospective Analysis of Predictors, Outcomes, and Detection

Metastatic Pattern of Truncal and Extremity Leiomyosarcoma: Retrospective Analysis of Predictors, Outcomes, and Detection

A Giant, Neglected Leiomyosarcoma on the Left Shoulder

Metastatic Pattern of Truncal and Extremity Leiomyosarcoma: Retrospective Analysis of Predictors, Outcomes, and Detection

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