A pooled analysis of risk factors of surgically treated leiomyosarcoma of the colon in adults

Abstract

Background: This current systematic review aimed to evaluate the role of surgical management and risk factors by pooled cases from all identified patients with colonic leiomyosarcomas. Methods: The authors searched the Ovid MEDLINE, Embase, PubMed, and Cochrane databases using the keywords "colonic," "colon," and "leiomyosarcoma." Risk factors of colonic leiomyosarcoma in the pooled cohort were also evaluated. Results: Between 1923 and 2019, 41 cases of colonic leiomyosarcoma were identified in 22 (53.7%) males and 19 (46.3%) females, with a mean and median age of 58.7 ± 2.2 years and 56.0 years. According to univariate analysis, smaller tumor size < 8 cm was significantly associated with longer progression-free survival (HR = 6.957, 95% CI 1.405-34.442; p = 0.017), and younger age < 60 years was trending toward better overall survival (HR = 2.765, 95% CI 0.924-8.272; p = 0.069). Conclusions: Colonic leiomyosarcomas are rare neoplasms with aggressive clinical behaviors. Age < 60 years and tumor size < 8 cm were favorable factors for patients' better survival. Literature search strategyThe search protocol, including the search questions and inclusion and exclusion criteria, was developed a priority according to the Preferred Reporting Items for systematic reviews and meta-analysis (PRISMA) guidelines. We performed a systematic literature research of the Ovid Medline, Embase, Pubmed, and Cochrane Library Database from 1923 to 2019. The keywords used in the search were "colonic," "colon," and "leiomyosarcoma." We further reviewed all the references provided in the publication and incorporate

Laparoscopic Right Hemicolectomy to Curatively Treat Primary Leiomyosarcoma at the Ileocecal Valve

“…As of 2019, 40 additional cases have been reported. 5 PLC represent only 0.12% of all colon malignancies. 2 , 3 PLC are most typically diagnosed during the fifth or sixth decades of life and slightly more frequent in men (53.7%) than in women (46.3%).…”

“… 1 The 5-year overall survival is 45.6% with a mean overall survival of 95.5 ± 18.6 months. 5 Recurrence rates of colorectal sarcomas ranging from 20 to 85% have been reported. 4 It was a challenge in determining the recurrence rates of our patient because there are relatively limited data to guide the medical team.…”

“…Typically, PLC metastasize to distance sites, mainly in the liver and lungs. 5 Multiple studies have shown that longer survival of patients with PLC was correlated with low tumor mitotic activity, smaller tumor size , 8 cm, and age , 60 years. 5,12 Currently, the most widely performed treatment of PLC is surgical resection, whereas the use of systemic adjuvant chemotherapy is still controversial and has not yet been established.…”

“… 1 , 4 PLC are aggressive tumors with a 5-year survival of 45.6%. 5 Because of the rarity and aggressiveness of PLC, studies on clinical features and treatments of this tumor are needed. Here, we present a case of PLC located at the ileocecal valve that was diagnosed by immunohistochemistry and curatively resected through laparoscopic surgery.…”

Giant leiomyosarcoma of the transverse colon

“…Approximately 5%–10% of LMS emerged from the smooth muscle cells in the wall of small blood vessels, the gastrointestinal tract and the uterus 2. Among that, gastrointestinal LMS of the colon accounts for less than 1% of all colorectal malignancies 3. The most common location is the stomach followed by the small intestine, colon and rectum 4.…”