Prognostic factors and survival outcomes of women with uterine leiomyosarcoma: A Turkish Uterine Sarcoma Group Study-003

Ayhan, Ali; Güngördük, Kemal; Khatib, Ghanim; Cüylan, Zeliha Fırat; Boran, Nurettin; Gökçü, Mehmet; Çelik, Hüsnü; Özgül, Nejat; Akbayır, Özgür; Şimşek, Tayup; Bakay, Abdülkadir; Köse, Mehmet; Tunç, Mehmet; Güleç, Ümran Küçükgöz; Koç, Sevgi; Kuşçu, Esra; Vardar, Mehmet Ali; Akıllı, Hüseyin; Taşkiran, Ç.; Meydanlı, Mehmet Mutlu

doi:10.1016/j.currproblcancer.2021.100712

Cited by 7 publications

(7 citation statements)

References 23 publications

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“… 18 5‐year survival rate has been documented to be approximately 50% in earlier stages, compared to 90% of most gynecologic cancers, 15 , 19 and drops dramatically at more advanced stages and when more aggressive histopathologic characteristics are present. 17 , 19 …”

Section: Discussionmentioning

confidence: 99%

“…These tumors in general are rare malignancies, comprising 1% of all uterine carcinomas, and are most frequently diagnosed in menopausal women with a history of uterine fibroids, usually during histologic analysis post‐myomectomy 15 . Incidence rates range from 0.4–0.6 per 100.000, 15,16 and early‐stage disease (FIGO Stages I and II) is diagnosed in approximately 70–87% of cases, 15,17 with tumors arising in pre‐menopausal women developing more aggressively (early‐stage disease 45%) 18 . 5‐year survival rate has been documented to be approximately 50% in earlier stages, compared to 90% of most gynecologic cancers, 15,19 and drops dramatically at more advanced stages and when more aggressive histopathologic characteristics are present 17,19 …”

Section: Discussionmentioning

confidence: 99%

“…18 5-year survival rate has been documented to be approximately 50% in earlier stages, compared to 90% of most gynecologic cancers, 15,19 and drops dramatically at more advanced stages and when more aggressive histopathologic characteristics are present. 17,19 With regard to β-hCG-producing uterine leiomyosarcomas, only 2 prior cases have ever been reported in the available literature. Liang et al 6 were the first to document the case of a 49-year-old woman with abnormal uterine bleeding persisting for months and a history of uterine fibroids, who on examination had elevated β-hCG levels, an advanced, spindle cell uterine leiomyosarcoma, and extensive peritoneal metastases in subsequent weeks.…”

Section: F I G U R E 4 Typical Histological Characteristics Of a High...mentioning

confidence: 99%

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Uterine malignant leiomyosarcoma associated with high levels of serum beta‐human chorionic gonadotropin: A case report

Tsakos¹,

Xydias

Ziogas

et al. 2022

Clinical Case Reports

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We present the case of a 54-year-old woman diagnosed with uterine leiomyosarcoma that produced beta-human chorionic gonadotropin (β-hCG), evident by both serum and immunohistologic examination. Based on this and similar cases from the available literature, β-hCG-producing sarcomas tend to have poorer prognosis, indicating that β-hCG could potentially be used as a marker of disease status and response to the therapy; however, this association is inconsistent and should be further investigated.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: F I G U R E 4 Typical Histological Characteristics Of a High...mentioning

confidence: 99%

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Uterine malignant leiomyosarcoma associated with high levels of serum beta‐human chorionic gonadotropin: A case report

Tsakos¹,

Xydias

Ziogas

et al. 2022

Clinical Case Reports

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“…The literature reports a percentage that can even touch 70% with a maximum survival of 70% at 5 years in stages I and II, while patients in more advanced stages see this percentage reduced up to just 10 months from diagnosis [ 56 , 57 ]. The main predictors of this trend are lymphovascular involvement, high mitotic index, high-grade nuclear atypia and disease stage but also tumor size and regional/distant metastases [ 58 , 59 ]. Regardless of histotype, in stage I–II operated patients, adjuvant radiotherapy does not reduce overall survival (OS) since it tends to decrease loco-regional but not distant metastasis [ 60 , 61 ].…”

Section: Discussionmentioning

confidence: 99%

An Extremely Rare Case of Disseminated Peritoneal Leiomyomatosis with a Pelvic Leiomyosarcoma and Omental Metastasis after Laparoscopic Morcellation: Systematic Review of the Literature

et al. 2022

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Minimally invasive treatment of uterine fibroids usually requires a power morcellation, which could be associated with several complications. A rare sequela is disseminated peritoneal leiomyomatosis. Indeed, recurrence or metastasis in these cases could be attributed to iatrogenic or under-evaluation of primary tumors, although a subset of cases is a sporadic sample of biological progression. We present an extremely rare case of a patient who underwent laparoscopic morcellation and after 12 years developed a pelvic leiomyosarcoma with two omental metastases, disseminated peritoneal leiomyomatosis with a parasite leiomyoma with bizarre nuclei and a parasite cellular leiomyoma simultaneously. The diagnosis was predicted preoperatively by an expert sonographer who recognized the ultrasound characteristics of uterine sarcoma and the localization of some of the masses, so the patient was referred to the gynaecological oncologists who could appropriately treat her. We present here a case report and a systematic review that could be a useful tool for further discussion and future clinical practice guidelines.

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“…Consequently, the NCCN recommends against lymphadenectomy for any subtype of uterine sarcoma [3]. On the other hand, other studies have associated lymphadenectomy with better OS of patients with HGESS/UUS and better disease-free survival (DFS) of patients with uLMS [9,10].…”

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confidence: 99%

Role of lymph node involvement and lymphadenectomy in patients with different subtypes of uterine sarcoma: a systematic review and meta-analysis

Fan

Zhang

Song

et al. 2023

Preprint

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Background We meta-analyzed the available data on the influence of lymph node involvement (LNI) and lymphadenectomy on the prognosis of patients with uterine sarcoma. Method PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, Scopus, OpenGrey, and ClinicalTrials.gov were searched for articles related to LNI or lymphadenectomy in patients diagnosed with any of the following subtypes of uterine sarcoma: uterine leiomyosarcoma (uLMS), low-grade endometrial stromal sarcoma (LGESS), high-grade endometrial stromal sarcoma (HGESS), undifferentiated uterine sarcoma (UUS), and adenosarcoma (ADS). Data on the incidence rates of LNI, lymphadenectomy, and survival were independently extracted and pooled using a random-effects model. Heterogeneity was evaluated using the I2 statistic. Result A total of 25 studies with 19,926 patients were included in our meta-analysis. LNI was more common in patients with HGESS/UUS [rate 18%; 95% confidence interval (CI) 95%: 9–28%], but less in uLMS (rate 6%; 95% CI 4–8%), LGESS (rate 7%; 95% CI 4–11%), or ADS (rate 2%; 95% CI 1–3%). Lymphadenectomy did not improve overall survival in patients with LGESS [hazard ratio (HR) 1.21, 95% CI 0.95–1.54], ADS (HR 0.90, 95% CI 0.73–1.10) or uLMS (HR 1.14, 95% CI 1.03–1.27), but it did improve overall survival in patients with HGESS/UUS (HR 0.63, 95% CI 0.48–0.85). Lymphadenectomy did not improve disease-free survival in patients with uLMS or ADS (HR 0.87, 95% CI 0.61–1.26). Conclusion LNI is relatively infrequent among patients with uLMS, LGESS, or ADS, and lymphadenectomy in such patients does not appear to improve survival. In contrast, LNI is relatively common among patients with HGESS/UUS, and lymphadenectomy significantly improves overall survival. The available evidence supports routine lymphadenectomy for patients with HGESS or UUS, but not those with uLMS, LGESS, or ADS. Trial registration: This meta-analysis registered with PROSPERO (CRD42022353507).

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Prognostic factors and survival outcomes of women with uterine leiomyosarcoma: A Turkish Uterine Sarcoma Group Study-003

Cited by 7 publications

References 23 publications

Uterine malignant leiomyosarcoma associated with high levels of serum beta‐human chorionic gonadotropin: A case report

Uterine malignant leiomyosarcoma associated with high levels of serum beta‐human chorionic gonadotropin: A case report

An Extremely Rare Case of Disseminated Peritoneal Leiomyomatosis with a Pelvic Leiomyosarcoma and Omental Metastasis after Laparoscopic Morcellation: Systematic Review of the Literature

Role of lymph node involvement and lymphadenectomy in patients with different subtypes of uterine sarcoma: a systematic review and meta-analysis

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