Primary leiomyosarcoma of the uterine cervix: report of 4 cases, systematic review, and meta-analysis

Kılıç, Çiğdem; Yüksel, Dilek; Çakır, Caner; Türkmen, Osman; Cömert, Günsu Kimyon; Başaran, Derman; Turan, Taner

doi:10.1177/0300891620919161

Cited by 6 publications

(8 citation statements)

References 41 publications

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“…Primary cervical leiomyosarcomas constitute 21% of all cervical sarcomas. [8,10] Hysterectomy should be the first choice of treatment in these patients according to other studies. Multimodality management may suitable for cervical leiomyosarcoma.…”

Section: Discussionmentioning

confidence: 96%

Primary sarcoma of the uterine cervix: Experience of a single center

Yuan

2022

Preprint

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Objectives To investigate the clinicopathological characteristics and prognosis of patients diagnosed with primary sarcoma of the uterine cervix. Methods We identified all patients with primary cervical sarcomas treated at our institution from 2002 to 2020. Clinical and pathologic variables, treatment modalities, and prognosis were abstracted from the medical records. Results Thirty-four patients were identified. Of these patients, 7 (20.6%) patients had leiomyosarcoma, 6 (17.6%) patients had carcinosarcoma or malignant mixed Müllerian tumor, 5 ( 14.7% ) patients had Ewing's sarcoma, 4 (11.8%) patients had rhabdomyosarcoma , 4 (11.8%) patients had undifferentiated sarcoma, 3 (8.8%) patients had sarcoma not otherwise specified, 2 (5.9%) patients had adenosarcoma, 2 (5.9%) patients had endometrial stromal sarcoma, and 1 (2.9%) patient had alveolar soft tissue sarcoma. The median age of the whole patients was 43.5 years (range, 13-63). The median age of patients with Ewing's sarcoma or rhabdomyosarcoma was 22 years (range, 13-39) and 17 years (range, 13-36), respectively. Twenty-four patients presented with vaginal bleeding which was the most common primary symptoms. The 2018 distribution by stage was: stage I in 21 (61.8%) patients, stage II in 4 (11.8%) patients, stage III in 6 (17.6%) patients and stage IV in 3 (8.8%) patients. Overall, 30 patients (88.2%) received surgical treatment and 4 patients (11.8%) with advanced disease received systematic chemotherapy with or without radiotherapy. The median follow-up was 33.3 months (range 3.6–187.3 months). 15 patients died during follow up, and 11 patients died within 2 years after diagnosis, most of them were patients with carcinosarcoma or undifferentiated sarcoma (45.5%, 5/11). In the entire cohort, 2-year overall survival (OS) and 5-year OS were 67.2% and 56.9%, respectively. For patients with different pathologic subtype, 5-year OS was 25.0% for undifferentiated sarcoma, 50.0% for rhabdomyosarcoma, 50.0% for carcinosarcoma, 53.3% for Ewing's sarcoma, 57.1% for leiomyosarcoma, and 75.0% for others. The 5-year OS for stage I-II and III-IV patients were 62.3% and 41.7%, respectively. Conclusions Cervical sarcomas are rare neoplasms with multiple histological subtypes and follow an aggressive course. Surgery is the main treatment for cervical sarcoma. Prognosis may be associated with tumor histology and stage.

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Section: Discussionmentioning

confidence: 96%

Primary sarcoma of the uterine cervix: Experience of a single center

Yuan

2022

Preprint

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“…Of all diagnosed cervical sarcomas, leiomyosarcomas make up 21%8. In 2020, a systematic international review found 42 cases reported in the literature 7 .…”

Section: Discussionmentioning

confidence: 99%

“…Performing a hysterectomy has been a significant predictor of disease-free survival. Still, the type of surgery (radical, modified radical, or extrafascial) does not indicate recurrence and has no impact on survival 7,14 .…”

Section: Discussionmentioning

confidence: 99%

“…They usually affect perimenopausal and postmenopausal women Medicina Universitaria between the fourth and sixth decade of life, and abnormal vaginal bleeding is the most common presenting symptom [4][5][6] . Due to the scarcity of information regarding this neoplasm, there is no standardized treatment, and its management is extrapolated from uterine sarcomas 7 and includes surgery, radiotherapy, and chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

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Primary leiomyosarcoma of the uterine cervix: A case report of an unusual neoplasia

Sánchez-Villegas¹,

Ruiz-Sánchez²,

Vidal-Gutiérrez³

et al. 2022

RMU

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Primary sarcomas of the cervix are rare neoplasms. Of all diagnosed cervical sarcomas, leiomyosarcomas correspond to 21% of cases. A 43-year-old woman presented with vaginal bleeding, and a pelvic ultrasound showed an image suggestive of a myoma during her approach. She underwent hysterectomy plus salpingo-oophorectomy, and the pathology study reported a high-grade leiomyosarcoma originating from the endocervix. Management with adjuvant radiotherapy was decided on, and 12 months later, she presented a recurrence of the disease, and chemotherapy was started. There is no established optimal treatment, and the available evidence is scarce.

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“…A slight association between TIM-3 and OS was observed in the younger group ( P = 0.046). Some studies demonstrate an age effect going in different directions ( 73 – 75 ). For example, Zhang et al reported that age (the elder group) was associated with a poorer prognosis ( 73 ).…”

Section: Discussionmentioning

confidence: 99%

TIM-3 as a Prognostic Marker and a Potential Immunotherapy Target in Human Malignant Tumors: A Meta-Analysis and Bioinformatics Validation

Zang¹,

Hui²,

Wang³

et al. 2021

Front. Oncol.

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BackgroundAs a novel immune checkpoint molecular, T-cell immunoglobulin mucin 3 (TIM-3) is emerging as a therapeutic target for cancer immunotherapy. However, the predictive role of TIM-3 in cancer remains largely undetermined. This study was designed to investigate the role of TIM-3 in cancer.MethodsPublications were searched using multiple databases. The hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated. To further confirm the prognostic effect of TIM-3, The Cancer Genome Atlas (TCGA) data were applied. Functional analysis of TIM-3 was also investigated.Results28 studies with 7284 patients with malignant tumors were identified. Based on multivariate Cox regression analysis, TIM-3 was an independent prognostic indicator for poor overall survival (OS) (HR= 1.54, 95% CI = 1.19-1.98, P = 0.001). However, TIM-3 was not correlated with cancer-specific survival and disease-free survival (DFS). Particularly, TIM-3 showed a worse prognosis in non-small cell lung carcinoma and gastric cancer; but it showed a favorable prognosis in breast cancer. Functional analysis showed that TIM-3 was closely correlated with immune responses such as T-cell activation and natural killer cell-mediated cytotoxicity. Moreover, TIM-3 expression was found to be related to worse OS in 9491 TCGA patients (HR = 1.2, P < 0.001), but was not associated with DFS.ConclusionsTIM-3 was an independent prognostic factor. Meanwhile, TIM-3 played a crucial role in tumor immune responses. This supports TIM-3 as a promising target for cancer immunotherapy.

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Primary leiomyosarcoma of the uterine cervix: report of 4 cases, systematic review, and meta-analysis

Cited by 6 publications

References 41 publications

Primary sarcoma of the uterine cervix: Experience of a single center

Primary sarcoma of the uterine cervix: Experience of a single center

Primary leiomyosarcoma of the uterine cervix: A case report of an unusual neoplasia

TIM-3 as a Prognostic Marker and a Potential Immunotherapy Target in Human Malignant Tumors: A Meta-Analysis and Bioinformatics Validation

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