Is differential expression of p16INK4a based on the classification of uterine smooth muscle tumors associated with a different prognosis? A meta-analysis

Cao, Hanyu; Yang, Sun; Wang, Shaopu; Deng, Liangliang; Lou, Jiangyan

doi:10.4238/gmr16019481

Cited by 6 publications

(6 citation statements)

References 24 publications

(35 reference statements)

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“…A recent study analyzed proteins p16, p53, Ki-67, estrogen receptor (ER), and progesterone receptor (PR) and illustrated that these proteins could be biomarkers for aggressive tissue (17). Further, expression of MIB-1, p53, and PR could be helpful for the differentiation of SMT, STUMP, and leiomyosarcoma (18)(19)(20)(21). Since the prognosis of leiomyosarcoma is much worse than that for STUMP, it is vital to determine the risk factors for relapse and leiomyosarcoma.…”

Section: Discussionmentioning

confidence: 99%

Oncologic and Reproductive Outcomes of Uterine Smooth Muscle Tumor of Uncertain Malignant Potential: A Single Center Retrospective Study of 67 Cases

Huo

Wang

et al. 2020

Front. Oncol.

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Background: The term "uterine smooth muscle tumor of uncertain malignant potential" (STUMP) indicates a rare tumor that cannot be classified as a benign leiomyoma or malignant leiomyosarcoma. In this study, we assessed the clinical characteristics, fertility, and oncologic outcomes of patients diagnosed as STUMP in 14 years. In addition, we analyzed the risk factors for recurrence in patients with STUMP. Methods: Medical records of STUMP patients at Peking Union Medical College Hospital (PUMCH) between January 2005 and June 2019 were reviewed and analyzed. Disease-free survival, age of diagnosis, tumor size, surgical procedure, pathology and immunohistochemistry, clinical characteristics, recurrence rate, and reproductive outcomes in the follow-up period were assessed. Univariate and multivariate analyses were performed to determine the prognostic factors. Results: The median age was 42 years old (range: 21-63). Total hysterectomy with or without bilateral salpingo-oophorectomy was performed in 29/67 cases (43.3%), and myomectomy was performed in 38/67 cases (56.7%). Ten patients experienced recurrences, and all but two recurrences occurred within 5 years after the initial surgery. Only two of these recurrences were leiomyosarcoma. There were no deaths in the median follow-up period of 48.4 (range 2.6-170.2) months. There were no remarkable differences in location of tumor between the myomectomy and hysterectomy groups, but the patients in the myomectomy group were younger than those in the hysterectomy group. In univariate and multivariate analysis, mitosis on pathology was the only independent risk factor for recurrence. Expression of Ki-67, p53, and p16 was significantly higher in patients with recurrence. Seven of the 35 patients who attempted to conceive had successful pregnancies. Huo et al. Uterine Smooth Muscle Tumor Outcomes Conclusions: The prognosis of STUMP was favorable and tumors with more than 10 mitoses per 10 high power field should be monitored closely. The surgical procedure was not an independent risk factor of recurrence, and myomectomy may be an acceptable option for patients wishing to preserve fertility.

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Section: Discussionmentioning

confidence: 99%

Oncologic and Reproductive Outcomes of Uterine Smooth Muscle Tumor of Uncertain Malignant Potential: A Single Center Retrospective Study of 67 Cases

Huo

Wang

et al. 2020

Front. Oncol.

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“…Recent studies have suggested the use of immunohistochemical stains, including epithelial growth factor receptor, galectin-3, p16, p16INK4a, p53, MIB-1, Twist, BCL-2, estrogen, and progesterone receptors to identify uterine smooth muscle tumors with a higher risk of recurrence [1516171819]. Although recurrent tumors regarded as STUMPs are associated with diffuse immunoreactivity for p16 and p53 [2021], the number of cases in these studies are small and further studies are needed to confirm the reliability of such markers.…”

Section: Discussionmentioning

confidence: 99%

Uterine smooth muscle tumor of uncertain malignant potential: fertility and clinical outcomes

et al. 2019

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Objective In this study, we aimed to evaluate the clinicopathological features, obstetric, and oncological outcomes of patients diagnosed with a uterine smooth muscle tumors of uncertain malignant potential (STUMP). Methods A dual-institutional, database review was carried out to screen patients with STUMP who were treated with upfront surgery between January 2006 and December 2017. Data including age at the time of diagnosis, recurrence rate, disease-free survival, overall survival, and fertility outcomes were retrospectively analyzed. Results Fifty-seven patients with STUMPs were included in the study. The median age at the time of diagnosis was 42 (range, 16 to 75) years. The median follow-up was 57 (range, 16 to 125) months. Eight patients (14%) had recurrence during follow-up. Recurrent STUMPs were seen in seven patients and leiomyosarcoma after 14 months in one patient. Seven patients with a recurrent STUMP survived, while the remaining patient died. Recurrence rates were similar for women who underwent myomectomy and those who underwent hysterectomy. The presence of uterine localization of tumor (subserosal vs intramural-submucosal) statistically significantly affected recurrence rates (odds ratio=5.72; 95% confidence interval=1.349–24.290; p=0.018). Ten of 27 patients who underwent myomectomy for uterine myoma had fertility desire. Seven pregnancies were recorded. Conclusions Our study results suggest that fertility-sparing approaches are feasible in patients with STUMP, although recurrence may be seen.

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“…Overexpression occurs in approximately 5% of leiomyomas and 50% of leiomyosarcoma [30,[33][34][35]. These figures, confirmed by a recent meta-analysis [37], suggest a negative correlation with differentiation and prognosis.…”

Section: Discussionmentioning

confidence: 88%

Neck subcutaneous nodule as first metastasis from broad ligament leiomyosarcoma: a case report and review of literature

Cazzato

D'Ercole

Luca³

et al. 2020

BMC Surg

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Background Leiomyosarcoma usually develops in the myometrium and is characterized by a high recurrence rate, frequent hematogenous dissemination, and poor prognosis. Metastasis is usually to lungs, liver, and bone, and occasionally to the brain, but seldom to the head and neck region. Primary leiomyosarcoma very rarely arises in the broad ligament. Case presentation A 54-year old woman presented to the otolaryngology department with a mass in the right posterior region of the neck 4 years after surgery for a primary leiomyosarcoma of the right broad ligament. The neck mass was removed and found to be a metastatic leiomyosarcoma. Leiomyosarcoma localizations in lungs and liver were absent. Morphological examination showed both the primary and the secondary leiomyosarcomas to have features of low-grade tumors. One year after excision of the neck mass, the patient presented with tachycardia. Echocardiography detected two intracardiac nodules suggestive of metastatic tumors. Chemotherapy was administered; the disease has been stable since then. Conclusions We report the first case of broad ligament leiomyosarcoma with the neck subcutaneous region being the first site of secondary involvement. We speculate that the Batson venous plexus might have been the pathway of dissemination.

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Is differential expression of p16INK4a based on the classification of uterine smooth muscle tumors associated with a different prognosis? A meta-analysis

Cited by 6 publications

References 24 publications

Oncologic and Reproductive Outcomes of Uterine Smooth Muscle Tumor of Uncertain Malignant Potential: A Single Center Retrospective Study of 67 Cases

Oncologic and Reproductive Outcomes of Uterine Smooth Muscle Tumor of Uncertain Malignant Potential: A Single Center Retrospective Study of 67 Cases

Uterine smooth muscle tumor of uncertain malignant potential: fertility and clinical outcomes

Neck subcutaneous nodule as first metastasis from broad ligament leiomyosarcoma: a case report and review of literature

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