Outcomes and Prognostic Factors for a Consecutive Case Series of 115 Patients with Somatic Leiomyosarcoma

Abraham, John A.; Weaver, Michael J.; Hornick, Jason L.; Zurakowski, David; Ready, John E.

doi:10.2106/jbjs.k.00460

Cited by 40 publications

(44 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Gladdy et al , in one of the larger series to date (353 patients with primary resectable LMS), found that although retroperitoneal location was associated with worse DSS compared to extremity or trunk tumors on univariate analysis, only grade and size (but not site of origin) were independent predictors of DSS and distant recurrence on multivariate analysis. Similarly, Abraham and colleagues , reporting on a series of 115 patients with somatic LMS (including soft tissue, retroperitoneal, vascular, and bone, but excluding uterine, gastrointestinal, and cutaneous forms), found that tumor grade, as well as depth and synchronous metastases (but not site of origin) were independent predictors of DSS.…”

Section: Discussionmentioning

confidence: 88%

Leiomyosarcoma: One disease or distinct biologic entities based on site of origin?

Worhunsky

Gupta

Gholami

et al. 2015

Journal of Surgical Oncology

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 88%

Leiomyosarcoma: One disease or distinct biologic entities based on site of origin?

Worhunsky

Gupta

Gholami

et al. 2015

Journal of Surgical Oncology

View full text Add to dashboard Cite

show abstract

“…Surgery is the cornerstone of treatment and is the only therapeutic modality proven to provide cure [ 5 ]. However, complete resection is often difficult due to large tumor size at presentation and recent studies have shown that resection margins may be the only significant predictor of local recurrence [ 4 , 15 ]. Moreover, complete primary surgical resection is critical for achieving the best overall outcome [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, complete primary surgical resection is critical for achieving the best overall outcome [ 16 ]. Other factors include tumor depth, histological grade, and metastasis at presentation [ 15 , 17 ]. The role of adjuvant chemotherapy in localized disease is not established and therefore is not standard treatment [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Metastatic mesenteric dedifferentiated leiomyosarcoma: a case report and a review of literature

et al. 2016

View full text Add to dashboard Cite

BackgroundAbdominal leiomyosarcoma arising from the mesentery is a rare malignancy. It is an aggressive entity with an overall 5 year survival rate between 20 and 30 %. Surgical resection is the cornerstone of primary treatment and may be curative for localized disease. However, patients often develop intra-abdominal relapse and/or metastatic disease. If surgical resection is not feasible, palliative chemotherapy is the treatment of choice. However, there are no clear guidelines regarding chemotherapy; neither in the adjuvant nor advanced setting.Case presentationWe present a 40 year-old woman, with a mesenteric leiomyosarcoma, who underwent radical tumor resection and did not receive adjuvant oncological therapy. Three months postoperatively, she developed metastatic disease to the lungs and liver. After multidisciplinary assessment she received an unconventional histological-subtype-tailored chemotherapy comprising 3–4 regimens. Initially, there was a decrease both in number and size of metastases. Ultimately, an almost complete radiological response was seen. Subsequent surgical resection and radiofrequency ablation of residual metastatic foci in the liver and lung brought her into complete clinical remission. She is presently tumor free, 36 months following diagnosis of metastatic disease.ConclusionsTo our knowledge, this is the first report of a patient with metastatic mesenteric leiomyosarcoma who is in complete clinical and radiological long-term remission following very aggressive multimodal treatment; including intense poly-drug chemotherapy and without any demonstrable long-term side effects. Given the rarity of mesenteric leiomyosarcoma and lack of guidelines regarding oncological therapy, we suggest that multimodal therapy including aggressive chemotherapy, guided by a multidisciplinary team, is essential to achieve an optimal outcome.

show abstract

“…They are microscopically similar to their deeper counterparts except that they are confined to the dermis with limited if any subcutaneous involvement, have a greater tendency for infiltrative rather than purely nodular growth, and have a lower incidence of tumor necrosis . Primary cutaneous leiomyosarcoma is considered a distinct disease entity from soft tissue or visceral leiomyosarcoma with an extremely low chance for metastasis, an indolent course and an excellent prognosis . Treatment is with wide local excision or Mohs micrographic surgery, and surgical margin status is the only predictor for recurrence .…”

Section: Discussionmentioning

confidence: 99%

Cutaneous scalp metastases from retroperitoneal leiomyosarcoma: a case report

et al. 2014

View full text Add to dashboard Cite

A 71-year-old woman presented with five scalp nodules that were clinically suspicious for pilar cysts. Histopathologic examination showed a proliferation of mitotically active pleomorphic spindle cells arranged into intersecting fascicles in the dermis and subcutis. Tumor cells displayed deeply eosinophilic cytoplasm and expressed desmin but were negative for S100 protein by immunohistochemistry. Before 10 years, the patient was diagnosed with high-grade retroperitoneal leiomyosarcoma and underwent resection with intraoperative radiation. Metastatic disease involving the lungs, liver and soft tissue developed, requiring treatment with resections, radiation and chemotherapy. Owing to the presentation of multiple scalp nodules with microscopic features of leiomyosarcoma in conjunction with the clinical history of retroperitoneal leiomyosarcoma, a diagnosis of metastatic leiomyosarcoma was made. Scalp metastasis from retroperitoneal leiomyosarcoma is extremely rare and portends a poor prognosis. To our knowledge, only two other cases have been reported in the English literature, and a further search discovered only nine additional cases of scalp metastasis from soft tissue leiomyosarcoma of any non-gynecologic anatomic site. This case highlights the striking microscopic similarity between primary cutaneous and metastatic leiomyosarcoma and illustrates the necessity of adequate clinical information and an appropriate index of suspicion in excluding the possibility of cutaneous metastases of leiomyosarcoma from somatic soft tissue.

show abstract

Outcomes and Prognostic Factors for a Consecutive Case Series of 115 Patients with Somatic Leiomyosarcoma

Abstract: Leiomyosarcoma is an aggressive disease, with a generally poor prognosis. Depth of tumor and high histological grade are indicators of a poor prognosis. Retroperitoneal tumors have a particularly high potential to metastasize.

Cited by 40 publications

References 19 publications

Leiomyosarcoma: One disease or distinct biologic entities based on site of origin?

Leiomyosarcoma: One disease or distinct biologic entities based on site of origin?

Metastatic mesenteric dedifferentiated leiomyosarcoma: a case report and a review of literature

Cutaneous scalp metastases from retroperitoneal leiomyosarcoma: a case report

Contact Info

Product

Resources

About