Leiomyosarcoma of the uterus

Stearns, Howard C.; Sneeden, Vinton D.

doi:10.1016/0002-9378(66)90120-7

Cited by 13 publications

(5 citation statements)

References 13 publications

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“…Although the standard initial surgical management of LMS of the uterus involves a total hysterectomy with BSO, the role of ovarian preservation remains controversial. A review of the literature on the outcome of hysterectomy and ovarian preservation demonstrated findings similar to those in the current study 16, 20, 22, 29, 43–48. To our knowledge, no investigation has indicated a significant, deleterious effect of preserving 1 or both ovaries on survival in patients with LMS of the uterus.…”

Section: Discussionsupporting

confidence: 84%

Prognostic factors and survival in 1396 patients with uterine leiomyosarcomas

Kapp¹,

Shin²,

Chan³

2008

Cancer

322

261

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BACKGROUND The objectives of the current study were to determine the prognostic factors associated with disease‐specific survival (DSS) and to analyze the role of lymphadenectomy (LND) and oophorectomy in the management of uterine leiomyosarcomas (LMS). METHODS Data were abstracted from the Surveillance, Epidemiology, and End Results database (1988–2003). Kaplan‐Meier and Cox proportional hazards regression models were used for analyses. RESULTS The median age of the 1396 patients was 52 years. There were 951 patients (68.1%) with International Federation of Gynecology and Obstetrics (FIGO) stage I disease, 43 patients (3.1%) with stage II disease, 99 patients (7.1%) with stage III disease, and 303 patients (21.7%) with stage IV disease. Distribution by tumor grade included 87 patients with grade 1 tumors, 208 with grade 2, and 509 patients with grade 3 tumors. The 5‐year DSS rates for patients with stage I, II, III, and IV disease were 75.8%, 60.1%, 44.9%, and 28.7%, respectively. Lymph node metastases were identified in 23 of 348 patients (6.6%) who underwent LND. The 5‐year DSS rate was 26% in patients who had positive lymph nodes compared with 64.2% in patients who had negative lymph nodes (P < .001). Of 341 patients aged <50 years with stage I or II disease, 240 (70.4%) underwent oophorectomy. There was no difference in 5‐year DSS based on oophorectomy. On multivariate analysis, older age at diagnosis, more recent year of diagnosis, African‐American race, higher tumor grade, higher stage of disease, and lack of primary surgical treatment all were associated significantly with worse survival. CONCLUSIONS Independent predictors of DSS in patients with uterine LMS included age, race, stage, grade, and primary surgery. Oophorectomy was not found to have an independent impact on survival. Cancer 2008. © 2008 American Cancer Society.

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Section: Discussionsupporting

confidence: 84%

Prognostic factors and survival in 1396 patients with uterine leiomyosarcomas

Kapp¹,

Shin²,

Chan³

2008

Cancer

322

261

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“…Kempson & Ban (2) stated that the sole criterion for malignancy is mitotic count, while others (3) require evidence of invasion. Some authors (4,5 ) include lesions in their series of LMS which are excluded by others (3,6,7). The variation in criteria for diagnosis might be a major cause for the wide range of reported relative incidence as well as of reported survival rates.…”

mentioning

confidence: 99%

Prognostic Factors in Uterine Leiomyosarcoma: A Clinical and Histopathological Study of 143 Cases the Radiumhemmet Series 1936-1981

et al. 1990

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One hundred and forty-three patients with uterine leiomyosarcomas treated at Radiumhemmet from 1936 through 1981 were reviewed. Clinical and histopathological findings were analysed by bivariate and multivariate analyses to assign prognostic factors. Mitotic count, menopausal status and stage showed to be significant predictors of survival. The series was divided into two periods of time and a significantly higher survival rate in the second period was noted for patients with stage I disease. Thirty-seven patients with tumors showing less than 10 mitotic figures per 10 high power fields had a 5-year survival rate of 65% compared with 17% for 106 patients with 10 or more mitotic figures per 10 high power field. No significant predictor of a bad outcome for these low mitotic count tumors was found.

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“…1,16,31 In our study, 56% of patients with leiomyosarcomas had concomitant leiomyomas, although none of the malignancies was seen to directly arise from a benign coexistent lesion. Our molecular data do suggest that there are some similarities in the mutational damage seen in benign uterine smooth muscle tumors and malignant uterine smooth muscle tumors.…”

Section: Discussionmentioning

confidence: 74%

Analysis of Allelic Loss as an Adjuvant Tool in Evaluation of Malignancy in Uterine Smooth Muscle Tumors

Esposito

Hunt²,

Bakker³

et al. 2006

The American Journal of Surgical Pathology

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Uterine smooth muscle tumors of uncertain malignant potential (STUMPs) are difficult both from the diagnostic and patient management standpoint because they cannot be classified as benign or malignant by conventional histologic criteria. This study's aim was to determine the diagnostic utility of allelic imbalance (AI) analysis in uterine smooth muscle tumors. Using microdissection and genotyping, we tested 5 leiomyomas, 6 STUMPs, and 10 leiomyosarcomas with follow-up for AI across a panel of seven tumor suppressor genes (p16, p21, p53, VHL, XRCC3, RB, and NM-23). None of the 6 patients with STUMP experienced recurrent disease, whereas 8 of the 10 patients diagnosed with leiomyosarcoma died of disease at follow-up. The mean frequency of allelic loss (FAL) for leiomyomas (18%) was not significantly different from that of STUMPs (21%) (P = 1), whereas leiomyosarcomas displayed a significantly higher FAL (52%) than both leiomyomas (P = 0.001) and STUMPs (P = 0.002). Loss of NM-23, a reported tumor metastasis suppressor gene, was found only in leiomyosarcomas (5 of 9, or 56%), and 4 of 5 (80%) of these were the only cases that demonstrated distant metastases (P = 0.04). Additionally, an FAL of >50% correlated with both NM-23 loss (P = 0.008) and distant metastatic disease (P = 0.04). In conclusion, leiomyomas and STUMPs displayed similar mean FALs and all were clinically benign, whereas uterine leiomyosarcomas had significantly higher frequencies of allelic loss than both leiomyomas and STUMPs. Molecular profiling may thus provide a valuable tool in assessment of malignancy in uterine smooth muscle tumors. Additionally, NM-23 is a promising candidate gene for determination of metastatic potential in these tumors.

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Leiomyosarcoma of the uterus

Cited by 13 publications

References 13 publications

Prognostic factors and survival in 1396 patients with uterine leiomyosarcomas

Prognostic factors and survival in 1396 patients with uterine leiomyosarcomas

Prognostic Factors in Uterine Leiomyosarcoma: A Clinical and Histopathological Study of 143 Cases the Radiumhemmet Series 1936-1981

Analysis of Allelic Loss as an Adjuvant Tool in Evaluation of Malignancy in Uterine Smooth Muscle Tumors

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