Soft tissue leiomyosarcoma—diagnostics, management, and prognosis: Data of the registry cancer of the center of Tunisia

Abstract

Background:Soft tissue leiomyosarcomas are rare, accounting for almost 5%–10% of all soft tissue sarcomas; they account for almost 1% of all sarcomas. They are aggressive tumors where location, size, and management require a multidisciplinary approach. Since there are few series published, we here analyze epidemiological pattern, clinical and pathologic features of soft tissue leiomyosarcomas.Methods:We conducted a retrospective study of 29 consecutive cases of histologically proven soft tissue leiomyosarcoma extracted from the database of the Cancer Registry of the Center of Tunisia and the Department of Pathology of Farhat Hached University Hospital of Sousse of Tunisia, during a 10-year period (from January 1996 to December 2005). Epidemiologic details, clinico-pathological features, and treatment modalities were assessed with focus on patients’ 5-year overall survival, tumor relapse, and metastases.Results:Soft tissue leiomyosarcoma accounted for 17.5% of all soft tissue sarcomas diagnosed at our pathology department. Most of patients were of advanced age (median: 52 years), with extremes ranging from 12 and 87 years. There was a slight male predominance (sex-ratio = 1.07). Tumors were located mostly in the lower limbs (45%). Deep sites as retroperitoneum was found only in two cases. Tumor size was more than 5 cm in 83% of cases (average size = 9.4 cm). Five cases had metastasis on initial staging. For 24 patients, the disease was locally limited at the moment of diagnosis. Palliative chemotherapy was indicated for four patients and surgery was performed for 20 patients. Local recurrence occurred in 11 patients (55% of operated patients) and metastasis in 6 patients. Overall, 5-year survival was about 24%.Conclusion:Our study results highlight the scarcity of soft tissue leiomyosarcoma. Unfortunately, unusual tumor sites, disease’s advanced stages, and intralesional resection made the prognosis poorer than in other series. Clinical course of soft tissue leiomyosarcoma was highly marked by local recurrence and metastasis.

Comparison of clinicopathological features and outcomes in patients with primary leiomyosarcoma of bone and soft tissue

“…PLB was first described by Evans and Sanerkin 11 and Overgaard et al, 12 who each identified an immunohistochemical profile of cytoplasmic myofilaments and dense bodies with various basal lamina fragments. Notably, this molecular pattern was similar to SLMS, which is more common than PLB and accounts for nearly 5–10% of adult soft tissue sarcoma 13 . Though given the rarity of PLB, there are few small series in which the natural disease course is described.…”

“…Few recent studies have demonstrated a survival benefit with surgery and adjuvant therapy in SLMS. Mestiri et al published the results of 29 consecutive cases of histologically proven SLMS, and in addition to high rates of local recurrence (55%) and initial metastases, they note the majority of patients (69%) underwent surgery, and they suggest surgery appears to be the cornerstone of treatment for SLMS 13 . More recently, Qian et al 4 found surgery and chemotherapy together improved survival in patients with SLMS and metastases at presentation.…”

Prediction of 5‐year survival in soft tissue leiomyosarcoma using a machine learning model algorithm

“…26,27 The clinical course of patients with LMS is often hard to predict as LMS is a highly aggressive tumor with propensity to metastasize. 2,5 Previous studies have used conventional univariate or multivariate statistical analyses to assess the magnitude of association a single variable has with an outcome such as overall survival. 24,28,29 To the best of our knowledge, this is the first study of its kind to use machine learning to assess prognosis of patients with trunk or extremity LMS.…”

“…Leiomyosarcoma (LMS) is a common subtype of soft tissue sarcoma (STS) arising from smooth muscle cells and accounting for 10−20% of all STS 1–3 . A heterogeneous and complex tumor, LMS encompasses various cytogenetic and molecular abnormalities 2,3 .…”

Treatment Outcomes of Leiomyosarcoma Metastasis Affecting the Brachial Plexus: A Comparative Case Report Using Chat Generative Pre-trained Transformer (ChatGPT)

“…Despite advancements in diagnostic and therapeutic strategies, the prognosis for leiomyosarcoma remains poor. The five-year survival rate ranges from 20% to 50% depending on the extent of the disease and the location of the tumor [ 3 ].…”