Abstract
BackgroundLeiomyosarcomas represent the largest subtype of soft tissue sarcomas. Two subgroups can be distinguished, non-uterine (NULMS) and uterine leiomyosarcomas (ULMS). The aim of this retrospective study was to evaluate differences in clinical features and outcome between these two subgroups.MethodsOutcome and clinical-pathological parameters between 50 patients with NULMS and 45 patients with ULMS were assessed, and compared between both groups. Univariate and multivariable survival analyses were performed.ResultsPatients with ULMS presented with larger tumors when compared to patients with NULMS (p < 0.001). More patients with ULMS initially presented with metastatic disease (67% vs. 36%, p = 0.007). Most common metastatic site was lung for both subtypes (28% and 38%). Five-year overall survival (OS) rates of 82.6% and 41.2% and median OS times of 92.6 (range: 79.7-105.4) and 50.4 (range: 34.8-66.0) months were observed in patients with NULMS and ULMS, respectively (p = 0.006). In multivariate analysis, initial metastatic disease remained an independent prognostic factor in terms of OS (p < 0.0001).ConclusionAt time of diagnosis ULMS were larger and more often metastasized. Therefore patients with ULMS showed unfavorable outcome when compared to NULMS. Later diagnosis might be caused by differences in symptoms and clinical presentation or a more aggressive biological tumor behavior.
Highlights
Leiomyosarcomas represent the largest subtype of soft tissue sarcomas
There was no survival-difference observed according to gender (p = 0.96) (Figures 4, 5 and 6). In this retrospective analysis comparing the clinical outcome of patients with Non-uterine leiomyosarcoma (NULMS) and uterine leiomyosarcomas (ULMS), we found significant differences in terms of clinical-pathological parameters and overall survival (OS) between these two groups
Patients with ULMS were found to have larger tumors and initial metastatic disease was more frequently observed at time of diagnosis
Summary
Two subgroups can be distinguished, non-uterine (NULMS) and uterine leiomyosarcomas (ULMS). The aim of this retrospective study was to evaluate differences in clinical features and outcome between these two subgroups. Leiomyosarcomas (LMS) are a rare large subgroup of all soft tissue sarcomas (STS) that account for approximately 24% of all STS. Management of initially localized NULMS consists of complete surgical resection and radiation therapy with overall survival of approximately 8-13 months [4]. For women with disease that has spread beyond the uterus but is confined to the peritoneal cavity surgical cytoreduction is recommended. In patients with metastatic disease that cannot be completely surgically resected administration of chemotherapy is favored over adjuvant radiation therapy RT. Chemotherapy in first line as well in advanced disease has shown promising results [10,11,12]
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