Prevalence and occult rates of uterine leiomyosarcoma

Abstract

This study aimed to assess the prevalence and occult rates of uterine leiomyosarcoma (ULMS) in women with smooth-muscle tumors undergoing gynecological surgery. A retrospective study was performed at an academic cancer center from 2008 to 2015. Patients undergoing either hysterectomy or myomectomy via laparoscopic, abdominal, vaginal, and hysteroscopic approaches were identified with the validated pathology diagnosis of either ULMS or leiomyomas. All patients initially operated at our institute were included and reviewed. The prevalence and occult rates of ULMS were calculated and compared between different age groups. Twenty-eight patients with original ULMS were identified in 9556 gynecological surgeries. The prevalence of overall and occult ULMS in our study was 0.25% (1 in 345 patients) and 0.07% (1 in 1429 patients). The proportion of occult in all ULMSs was 25%. The prevalence rates of overall ULMS were 0.21%, 0.13%, 0.52%, 2.12%, and 6.67% in the 30 to 39, 40 to 49, 50 to 59, 60 to 69, and ≥70-year age groups, respectively. There was a significantly increased risk of ULMS after 50 years of age. The prevalence rates of occult ULMS were 0.05%, 0.08%, and 0.12% for the 30 to 39, 40 to 49, and 50 to 59 year age groups, respectively. There was no statistically significant difference among age the groups. The prevalence of ULMS was 0.41% and 0.16% for solitary and multiple tumor masses, respectively. Patients with solitary uterine tumors were at a significantly increased risk of ULMS (OR = 2.601, 95% CI = 1.108–6.141). Our retrospective data in part reflects the clinical characteristics of overall and occult ULMS and forms the basis for further prevention of occult ULMS.

Retrospective Analysis of Patients with Gynaecological Uterine Sarcomas in a Tertiary Hospital

“…However, no statistically significant differences were observed with respect to OS or with respect to DFS among the different histological subtypes. Finally, although the literature shows that patients with the ESS subtype have the best prognosis [19,23,26], we found a lower OS and a lower DFS in the ESS group, without reaching significance. These differences are probably due to the fact that in our sample 77% of ESS were high-grade.…”

“…Regarding the clinical presentation, we found significant differences among the subgroups, highlighting bleeding in the CS group (84.9%) and incidental finding in surgical specimens in the LMS group (45%), similar to those reported by Van Den Haak et al [22] and higher than those described by Wang et al, 25% [23]. Specifically, for LMSs, a presurgical diagnosis of leiomyoma is suspected, and subsequently, the histopathological analysis reveals tumour cell growth.…”

Five-Year Retrospective Study of Uterine STUMP and Leiomyosarcoma

“…They have a frequency of approximately 0.01%, their prevalence being difficult to assess due to their rarity and variable/subjective diagnostic criteria [ 12 , 13 ]. The incidence of uterine leiomyosarcoma is between 0.35–0.8/100,000, with a prevalence of 3–7/100,000 [ 14 , 15 , 16 ]. The scarcity of this pathology was also identified in our study, establishing a frequency of 0.36% in STUMP and 1.08% in leiomyosarcoma.…”

Morphological and Ancillary Features of Uterine Leiomyosarcoma: Case Report

“… 1 Leiomyosarcomas account for almost 70% of these tumors, with a variable incidence ranging from 0.35 to 0.8/100 000 women. 2 - 4 In this tumor category, the 5-year survival is 25% to 76% and only 10% to 15% in the case of metastatic disease at the time of diagnosis. 2 Its poor prognosis and the high rate of recurrence require establishment of a correct and prompt diagnosis followed by surgical therapy, which is the most effective, especially in earlier stages.…”