Prognostic factors and impact of adjuvant chemotherapy for uterine leiomyosarcoma

Wu, Ting-Jung; Chang, Ting Chang; Hsueh, Swei; Hsu, Kuang‐Hung; Chou, Hung Hsueh; Huang, Hsuan-Rong; Lai, Chyong‐Huey

doi:10.1016/j.ygyno.2005.08.010

Cited by 102 publications

(109 citation statements)

References 23 publications

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“…The study periods spanned the 1990s and/or 2000s, and dated back to the 1980s for 9 studies (Hsieh et al, 2003;Campbell et al, 2004;Hsu et al, 2004;Dickinson et al, 2006;Wu et al, 2006;Kim et al, 2007;2008c;Huang et al, 2010;Han et al, 2011) and the 1970s for 1 study (Wang et al, 2009) (Table 1). The number of patients [minimum, 12 (Jun et al, 2010); maximum, 324 (Dickinson et al, 2006) was fewer than 50 in 17 of the 32 studies.…”

Section: Study and Patient Characteristicsmentioning

confidence: 99%

“…The number of patients [minimum, 12 (Jun et al, 2010); maximum, 324 (Dickinson et al, 2006) was fewer than 50 in 17 of the 32 studies. Only 13 studies specified whether STS was primary or recurrent [8 primary (Dickinson et al, 2006;Hui et al, 2006;Wu et al, 2006;An et al, 2007;Kim et al, 2008a;Ng and Tan, 2009;Wang et al, 2009;Liu et al, 2010); 5 primary or recurrent (Hsieh et al, 2003;Kiatisevi et al, 2006;Moncrieff et al, 2008;Miki et al, 2010;Cho et al, 2011)]. Patients had local disease in 15 studies (Choong et al, 2003;Campbell et al, 2004;Hsu et al, 2004;Dickinson et al, 2006;Hui et al, 2006;An et al, 2007;Kim et al, 2007;2008c;Pervaiz et al, 2008;Rudiger et al, 2009;Wang et al, 2009;Liu et al, 2010;Cho et al, 2011;Han et al, 2011), and local or metastatic disease in 7 studies (Wu et al, 2006;Chan et al, 2008;Moncrieff et al, 2008;Koh et al, 2009;Jun et al, 2010;Park et al, 2010;Lee et al, 2011).…”

Section: Study and Patient Characteristicsmentioning

confidence: 99%

“…The remaining 10 studies did not specify whether disease was local or metastatic. Overall, pleomorphic (Huang et al, 2006;Lin et al, 2006;Huang et al, 2008;Huang et al, 2010) report data from a single group of patients over time, only data from the most recent publication (Huang et al, 2010) were reviewed (23) 124 ( (Jun et al, 2010) to 73% (Hong et al, 2010), excluding 4 studies of female patients with uterine and endometrial sarcomas (Hsieh et al, 2003;Wu et al, 2006;Kim et al, 2008a;.…”

Section: Study and Patient Characteristicsmentioning

confidence: 99%

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Soft-tissue Sarcomas in the Asia-Pacific Region: A Systematic Review

Ngan¹,

Wang²,

Porter³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Asian Pac J Cancer Prev, 14 (11), [6821][6822][6823][6824][6825][6826][6827][6828][6829][6830][6831][6832] Introduction Soft-tissue sarcomas (STS) are a heterogeneous group of rare tumours. More than 50 STS histotypes have been identified, with most having unique clinical, prognostic, and therapeutic features. Although less than 1% of all adult malignant tumours are STS (Fletcher et al., 2002a), their treatment and management is complex because many tumour-related (eg, histotype, site, size, depth, grade, primary vs recurrent) (Singer et al., 1994;2000;Pisters et al., 1996) and treatment-related (eg, surgical margins, use of adjuvant therapy) (Singer et al., 2000) factors influence patient outcomes. Because these factors are inherently variable and because STS is rare, the management of patients with STS is best undertaken by an experienced multidisciplinary team in specialist centres to minimise recurrence, maximise survival, and preserve functionality and quality of life (Ray-Coquard et al., 2004;Luis et al., 2010; National Comprehensive Cancer Network, 2012).The standard primary treatment for STS is surgical AbstractBackground: Soft-tissue sarcomas require tailored and multidisciplinary treatment and management. However, little is known about how sarcomas are treated and managed throughout the Asia-Pacific region. Materials and Methods: MEDLINE was systematically searched using prespecified criteria. Publications (previous 10 years) that reported tumour characteristics, treatment patterns, survival outcomes, and/or safety outcomes of patients with soft-tissue sarcoma were selected. Exclusion criteria were studies of patients <18 years of age; ≤10 patients; countries other than Australia, Hong Kong, Indonesia, Korea, Malaysia, New Zealand, Philippines, Singapore, Taiwan, or Thailand; >20% benign tumours; sarcomas located in bones or joints; gastrointestinal stromal tumour; Kaposi's sarcoma; or not reporting relevant outcomes. Results: Of the 1,822 publications retrieved, 35 (32 studies) were included. Nearly all patients (98%, 1,992/2,024; 31 studies) were treated with surgery, and more studies used adjuvant radiotherapy than chemotherapy (24 vs 17 studies). Survival outcomes and recurrence rates varied among the studies because of the different histotypes, sites, and disease stages assessed. Only 5 studies reported safety findings. Conclusions: These findings highlight the lack of specific data available about soft-tissue sarcomas in the Asia-Pacific region. Better efforts to understand how the sarcoma is managed and treated will help improve patient outcomes in the region.

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Section: Study and Patient Characteristicsmentioning

confidence: 99%

Section: Study and Patient Characteristicsmentioning

confidence: 99%

Section: Study and Patient Characteristicsmentioning

confidence: 99%

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Soft-tissue Sarcomas in the Asia-Pacific Region: A Systematic Review

Ngan¹,

Wang²,

Porter³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…It is worth noting that, when adjusted for stage and mitotic count, LMS has a significantly worse prognosis than carcinosarcoma (Miettinen and Fetsch, 2006). As uterine LMS is resistant to chemotherapy and radiotherapy and surgical intervention is virtually the only therapeutic approach (Brooks et al, 2004;Dusenbery et al, 2004;Wu et al, 2006), an efficient adjuvant therapy is required to improve the prognosis of the disease. Although cases accompanied by hypocalcaemia or eosinophilia have been reported, neither clinical abnormality is an initial risk factor for uterine LMS.…”

Section: Introductionmentioning

confidence: 99%

Mice-lacking LMP2, immuno-proteasome subunit, as an animal model of spontaneous uterine leiomyosarcoma

et al. 2010

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Uterine tumors are the most common type of gynecologic neoplasm. Uterine leiomyosarcoma (LMS) is rare, accounting for 2% to 5% of tumors of the uterine body. Uterine LMS develops more often in the muscle tissue layer of the uterine body than in the uterine cervix. The development of gynecologic tumors is often correlated with female hormone secretion; however, the development of uterine LMS is not substantially correlated with hormonal conditions, and the risk factors are not yet known. Radiographic evaluation combined with PET/CT can be useless in the diagnosis and surveillance of uterine LMS. Importantly, a diagnostic biomarker, which distinguishes malignant LMS and benign tumor leiomyoma (LMA) is yet to be established. Accordingly, it is necessary to analyze risk factors associated with uterine LMS in order to establish a method of treatment. LMP2-deficient mice spontaneously develop uterine LMS, with a disease prevalence of~40% by 14 months of age. It is therefore of interest whether human uterine LMS shows a loss of LMP2 expression. We found LMP2 expression is absent in human LMS, but present in human LMA. Therefore, defective LMP2 expression may be one of the risk factors for LMS. LMP2 is potentially a diagnostic biomarker for uterine LMS, and gene therapy with LMP2-encording DNA may be a new therapeutic approach.

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“…Since uterine LMS is resistant to chemotherapy and radiotherapy and surgical intervention is virtually the only means of treatment, the development of an efficient adjuvant therapy is expected to improve the prognosis of this disease (7)(8)(9). Matrix metallo-proteinases (MMPs), which degrade components of the extracellular matrix, appear to participate in tumour invasion and metastasis, and a trend towards prolonged disease-free survival has been seen in patients with MMP2-negative tumours (10,11).…”

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confidence: 99%

Molecular Pathology and Novel Clinical Therapy for Uterine Leiomyosarcoma

Hayashi

Kawano

Ichimura

et al. 2016

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Abstract. Patients with uterine leiomyosarcoma (LMS)typicallyUterine mesenchymal tumours have been traditionally divided into benign leiomyomas (LMA) and malignant leiomyosarcomas (LMS), based on cytological atypia, mitotic activity, and other criteria. Globally, uterine LMSs, which are some of the most common neoplasms in the female genital tract, are relatively rare mesenchymal tumours, having an estimated annual incidence of approximately one per 160,000 women (1). They account for approximately one-third of uterine sarcomas and 1.3% of all uterine malignancies, and are considered aggressive malignancies, with a 5-year survival rate of only 50% for patients with tumours confined to the uterus (2, 3). It is noteworthy that when adjusting for 4997 This article is freely accessible online.

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Prognostic factors and impact of adjuvant chemotherapy for uterine leiomyosarcoma

Cited by 102 publications

References 23 publications

Soft-tissue Sarcomas in the Asia-Pacific Region: A Systematic Review

Soft-tissue Sarcomas in the Asia-Pacific Region: A Systematic Review

Mice-lacking LMP2, immuno-proteasome subunit, as an animal model of spontaneous uterine leiomyosarcoma

Molecular Pathology and Novel Clinical Therapy for Uterine Leiomyosarcoma

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