Current Status of Uterine Leiomyosarcoma in the Tohoku Region: Results of the Tohoku Translational Center Development Network Survey

Tokunaga, Hideki; Takahashi, Fumiaki; Yamamoto, Hiroki; Honda, Tsuyoshi; Watanabe, Takafumi; Shoji, Tadahiro; Sugiyama, Toru; Yamada, Hidekazu; Tando, Tomoe; Yoshinaga, Kosuke; Kagabu, Satoko; Otsuki, Takeo; Kin, Shogo; Yokoyama, Yoshihiko; Wagatsuma, S.; Sato, K.; Sato, Hírokazu; Oishi, Takashi; Yoshida, Yūji; Hayasaka, Tadashi; Matsui, Takayoshi; Imai, Norikazu; Nishigori, Hidekazu; Shimokawa, Hiroaki; Yaegashi, Nobuo; Watanabe, Yoh

doi:10.1007/s10147-017-1097-y

Cited by 2 publications

(1 citation statement)

References 23 publications

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“…However, systemic staging surgery with an oophorectomy and LND is controversial in stage I uLMS (8). There is a consensus that ovaries should be removed in postmenopausal women (21). Most studies have found that ovarian preservation is safe in stage I premenopausal women, who have similar relapse and survival rates to women who undergo BSO (22).…”

Section: Second-look Surgerymentioning

confidence: 99%

Management of stage I occult uterine leiomyosarcoma: effects of morcellation, second-look surgery, and adjuvant treatments on survival

Yang¹,

Yang²,

Cao³

et al. 2022

Ann Transl Med

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Background: This study sought to analyze the risk of morcellation in patients who underwent surgery for leiomyoma and had a final pathological diagnosis of uterine leiomyosarcoma (uLMS), and evaluate the survival benefits of second-look surgery and chemotherapy in patients with stage I occult uLMS.Methods: A retrospective analysis of the data of patients with occult stage I uLMS in the Peking Union Medical College Hospital database between 2005 and 2018 was conducted. The recurrence rate and progression-free survival (PFS) were compared between patients who underwent morcellation or not.Univariate analyses were used to evaluate the survival impact of lymphadenectomy, oophorectomy and adjuvant chemotherapy. Propensity-score matching methods were used to evaluate the effect of morcellation on recurrence while adjusting for baseline confounding factors using Poisson regression fitted by inverse probability weighting (IPW) estimation.Results: A total of 96 patients with uLMS were identified among the 31,679 surgeries performed for leiomyomas (incidence: 0.303%). Hysterectomy was performed in 60 patients, and myomectomy was performed in 36 patients (power morcellation n=20). There were 36 (37.5%) patients underwent lymphadenectomy, and 76 (79.2%) patients underwent oophorectomy. Among them, 47 (52.8%) patients received postoperative chemotherapy. The median follow-up time was 40 months (range, 12-146 months), and there were 43 cases of recurrence (44.7%). No differences in recurrence were found between the hysterectomy and myomectomy groups (hazards ratio 0.839, P=0.701). The 3-year PFS rates for patients with hysterectomy, power morcellation, and non-power morcellation were 64.3%, 53.8%, and 59.8%, respectively. No survival differences were identified between patients with/without lymphadenectomy [PFS: P=0.513; overall survival (OS): P=0.413] and oophorectomy (PFS: P=0.162; OS: P=0.815). Postoperative chemotherapy was associated with better PFS (P=0.047), but not OS (P=0.36).Conclusions: No survival differences were observed among the initial surgical procedures in stage I patients with occult uLMS. No survival benefits were observed between lymphadenectomy and oophorectomy patients. Compared to continued observation, postoperative chemotherapy was associated with improved PFS, but not OS.

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Section: Second-look Surgerymentioning

confidence: 99%

Management of stage I occult uterine leiomyosarcoma: effects of morcellation, second-look surgery, and adjuvant treatments on survival

Yang¹,

Yang²,

Cao³

et al. 2022

Ann Transl Med

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The systemic treatment of uterine leiomyosarcomas

Kyriazoglou¹,

Liontos²,

Ntanasis‐Stathopoulos³

et al. 2021

Medicine

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Background: Uterine leiomyosarcomas are rare malignant mesenchymal tumors. The systemic treatment of these tumors includes chemotherapy and radiotherapy. However, there are still a lot of unanswered questions regarding the ideal therapeutic approach. Methods: We have conducted a systematic review of the treatment strategies of uterine leiomyosarcomas for the last ten years. Results: Adjuvant chemotherapy is still a matter of dilemma. Doxorubicin based chemotherapy or the combination of Gemcitabine-Docetaxel are the regimens of choice for the first line setting. Beyond the first line, there are several options;, including chemotherapy, targeted therapy, and recently efforts of introducing immunotherapy to the therapeutic armamentarium of clinicians treating uterine leiomyosarcomas. Conclusions: Despite the efforts of the clinicians dealing with uterine leiomyosarcomas, the optimal therapeutic algorithm is yet to be described.

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Current Status of Uterine Leiomyosarcoma in the Tohoku Region: Results of the Tohoku Translational Center Development Network Survey

Abstract: Although ULMS was associated with a high rate of complete or optimal surgery, the long-term prognosis was poor. Effective postoperative therapy should be developed to improve the long-term prognosis of patients with ULMS.

Cited by 2 publications

References 23 publications

Management of stage I occult uterine leiomyosarcoma: effects of morcellation, second-look surgery, and adjuvant treatments on survival

Management of stage I occult uterine leiomyosarcoma: effects of morcellation, second-look surgery, and adjuvant treatments on survival

The systemic treatment of uterine leiomyosarcomas

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