Prognostic Factors and Outcomes in 28 Cases of Uterine Leiomyosarcoma

Loizzi, Vera; Cormio, Gennaro; Nestola, D.; Falagario, M; Surgo, A.; Camporeale, A; Putignano, G; Selvaggi, Luigi

doi:10.1159/000331679

Cited by 16 publications

(15 citation statements)

References 30 publications

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“…Concurrent and complete surgical excision of the primary as well as caval disease remains the standard of care for these patients 6 7 12. The role of adjuvant chemotherapy, radiotherapy and hormonal therapy remains unclear in patients with leiomyosarcoma, as long-term outcomes and data are lacking 1 13…”

Section: Discussionmentioning

confidence: 99%

Successful removal of uterine leiomyosarcoma tumour thrombus propagating to the right atrium

et al. 2015

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SUMMARYAlthough intravenous leiomyomatosis is widely documented, intravenous extension of leiomyosarcoma into the inferior vena cava (IVC) and subsequently into the right atrium is extremely rare. Less than five such cases have been reported in the literature worldwide. Uterine leiomyosarcoma is an aggressive smooth muscle tumour occurring with an incidence of 1% in all female genital tract cancers and comprises about 3-7% of uterine cancers. It carries a generally poor prognosis with 5-year survival rates ranging from 18.8% to 65% across all stages. We report a case of primary uterine leiomyosarcoma with intravascular tumour propagation extending to the renal vein, IVC and right atrium of the heart, which was successfully resected in a one stage operation by a multidisciplinary team. This case demonstrates the importance of preoperative radiological staging and multidisciplinary planning. BACKGROUND

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Section: Discussionmentioning

confidence: 99%

Successful removal of uterine leiomyosarcoma tumour thrombus propagating to the right atrium

et al. 2015

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“…Uterine LMS affects 6 out of 1 million women annually [3–5] and, although rare, this is a deadly disease with a recurrence rate often greater than 60% [5, 6, 13, 23]. The series examining similar groups are small; however, surgery seems to be the treatment of choice for those with first time recurrent disease in selected patients.…”

Section: Discussionmentioning

confidence: 99%

“…The series examining similar groups are small; however, surgery seems to be the treatment of choice for those with first time recurrent disease in selected patients. Specifically, those with resectable disease from initial low stage disease and low-grade tumors might benefit the most with operative cytoreduction in this setting [4, 6, 7, 13]. Due to the limited number of patients affected and known benefits of surgical treatment, randomized controlled studies are not feasible.…”

Section: Discussionmentioning

confidence: 99%

“…Due to the limited number of patients affected and known benefits of surgical treatment, randomized controlled studies are not feasible. Hence, management and prognostic factors have only been determined based on retrospective data [4, 7, 13, 14]. Furthermore, uterine LMS is a separate biologic entity with a different prognosis from the other uterine sarcomas and it must be uniquely separated from other primary uterine sarcomas.…”

Section: Discussionmentioning

confidence: 99%

“…Due to the paucity of published data, prognostic factors as a guide for management options are limited [18, 22, 23, 25, 26]. Once recurrence has been diagnosed, the reported survival of these patients is as low as 5 months [13]. Only a few have reported outcome and prognostic factors of patients with first time recurrence solely for uterine LMS [22, 23].…”

Section: Discussionmentioning

confidence: 99%

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Prognostic Factors and Survival in Patients Treated Surgically for Recurrent Metastatic Uterine Leiomyosarcoma

Hoang

Ensor

Rosen

et al. 2014

International Journal of Surgical Oncology

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Background. Uterine leiomyosarcoma (LMS) is a rare diagnosis, which is seldom cured when it recurs with metastatic disease. We evaluated patients who present with first time recurrence treated surgically to determine prognostic factors associated with long-term survival. Methods. Over a 16-year period, 41 patients were operated on for recurrent uterine sarcoma. Data examined included patient age, date of initial diagnosis, tumor histology, grade at the initial diagnosis, cytopathology changes in tumor activity from the initial diagnosis, residual tumor after all operations, use of adjuvant therapy, dates and sites of all recurrences, and disease status at last followup. Results. 24 patients were operated for first recurrence of metastatic uterine LMS. Complete tumor resection with histologic negative margins was achieved in 16 (67%) patients. Overall survival was significantly affected by the FIGO stage at the time of the initial diagnosis, the ability to obtain complete tumor resection at the time of surgery for first time recurrent disease, single tumor recurrence, and recurrence greater than 12 months from the time of the initial diagnosis. Median disease-free survival was 14 months and overall survival was 27 months. Conclusion. Our findings suggest that stage 1 at the time of initial diagnosis, recurrence greater than 12 months, isolated tumor recurrence, and the ability to remove ability to perform complete tumor resection at the time of the first recurrence can afford improved survival in selected patientsat the time of the first recurrence can afford improved survival in selected patients.

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