Liver-directed treatments of liver-dominant metastatic leiomyosarcoma

Krzyston, H.; Morse, Brian; DePeralta, Danielle K.; Rishi, Anupam; Kayaleh, R.; El-Haddad, Ghassan; Smith, J. Joshua; Druta, Mihaela; Kis, Béla

doi:10.5152/dir.2020.19405

Cited by 8 publications

(6 citation statements)

References 25 publications

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“…The most common symptoms were fatigue, nausea, and right upper quadrant abdominal pain. The majority of laboratory adverse events were mild and reversible liver function test abnormalities, which was also similar to prior retrospective series [ 19 , 34 ]. We had one case of REILD in a patient with normal liver function at baseline who had TARE of the entire liver and systemic chemotherapy 3 weeks after TARE [ 48 ].…”

Section: Discussionsupporting

confidence: 86%

“…However, there are very few studies describing the efficacy and safety of LDTs in patients with primary or metastatic hepatic sarcomas. Most of these studies focus on TACE or TABE, reporting modest rates of tumor response and improved survival [ 32 , 33 , 34 , 35 ]. The only data available for TARE in hepatic sarcomas come from one multi-institutional retrospective study and case reports [ 19 , 36 , 37 ].…”

Section: Discussionmentioning

confidence: 99%

“…Another study with TACE in patients with secondary hepatic STS showed a median OS of 13 months, with OS of 67% and 40% at 1- and 3 years post-procedure, respectively [ 33 ]. Additional studies with TABE, TACE, TARE, or microwave ablation showed median OS ranging from 9 to 26.7 months and median LPFS of 9 to 14.2 months [ 34 , 35 ]. A study from Miller et al on TARE in patients with primary or metastatic liver sarcomas showed a median OS of 30 months (95% CI: 12–43 months), with 1-year and 3-year OS rates of 83% and 37%, respectively [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

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Efficacy and Safety of Trans-Arterial Yttrium-90 Radioembolization in Patients with Unresectable Liver-Dominant Metastatic or Primary Hepatic Soft Tissue Sarcomas

Testa

Bui

Wang

et al. 2022

Cancers

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Patients with liver-dominant metastatic or primary hepatic soft tissue sarcomas (STS) have poor prognosis. Surgery can prolong survival, but most patients are not surgical candidates, and treatment response is limited with systemic chemotherapy. Liver-directed therapies have been increasingly employed in this setting, and Yttrium-90 trans-arterial radioembolization (TARE) is an understudied yet promising treatment option. This is a retrospective analysis of 35 patients with metastatic or primary hepatic STS who underwent TARE at a single institution between 2006 and 2020. The primary outcomes that were measured were overall survival (OS), liver progression-free survival (LPFS), and radiologic tumor response. Clinical and biochemical toxicities were assessed 3 months after the procedure. Median OS was 20 months (95% CI: 13.9–26.1 months), while median LPFS was 9 months (95% CI: 6.2–11.8 months). The objective response rate was 56.7%, and the disease control rate was 80.0% by mRECIST at 3 months. The following correlated with better OS post-TARE: liver disease control (DC) at 6 months (median OS: 40 vs. 17 months, p = 0.007); LPFS ≥ 9 months (median OS: 50 vs. 8 months, p < 0.0001); ECOG status 0–1 vs. 2 (median OS: 22 vs. 6 months, p = 0.042); CTP class A vs. B (median OS: 22 vs. 6 months, p = 0.018); and TACE post-progression (median OS: 99 vs. 16 months, p = 0.003). The absence of metastases at diagnosis was correlated with higher median LPFS (7 vs. 1 months, p = 0.036). Two grade 4 (5.7%) and ten grade 3 (28.6%) laboratory toxicities were identified at 3 months. There was one case of radioembolization-induced liver disease and two cases of radiation-induced peptic ulcer disease. We concluded that TARE could be an effective and safe treatment option for patients with metastatic or primary hepatic STS with good tumor response rates, low incidence of severe toxicity, and longer survival in patients with liver disease control post-TARE.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Efficacy and Safety of Trans-Arterial Yttrium-90 Radioembolization in Patients with Unresectable Liver-Dominant Metastatic or Primary Hepatic Soft Tissue Sarcomas

Testa

Bui

Wang

et al. 2022

Cancers

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“…Other factors were associated with the development of distant metastasis including large size, deep location and recurrent disease The most common metastatic sites are lungs, liver and bone (4,5,13).…”

Section: Resultsmentioning

confidence: 99%

“…Doxorubicin is the firstline chemotherapy for patients with unresecable metastatic leiomyosarcoma. Liver-directed therapies (transarterial chemoembolization, radioembolisation and microwave ablation) are promising alternatives to systemic chemotherapy (4,20).…”

Section: Resultsmentioning

confidence: 99%

Surgical Management of Large Liver Metastases from Urinary Bladder Leiomyosarcoma

Hajri

Omrani

Zouari

et al. 2021

ARS Medica Tomitana

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Leiomyosarcoma is a malignant tumor developed from the smooth muscle. It can arise in different sites especiallyin gastrointestinal tract (stomach, small bowel and colon), genitourinary tract (uterus, bladder and kidney) and the retroperitoneum (inferior vena cava) (1,2). It’s localization in the bladder is rare, representing 0.5% of all urinary bladder malignancies. There are over 210 cases reported in literature(3).Ten to 30% of the patients willpossibly develop metastases and the most common sites are lungs, liver and bone(4,5). There is no concensus on a standard treatment due to its very low incidence. We report here a rare case of a surgical management of large liver metastases from urinary bladder leiomyosarcoma.

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