Retrospective Analysis of Outcome of Patients with Metastatic Leiomyosarcoma in a Tertiary Referral Center

Abstract

Background: Leiomyosarcoma is a common subtype of soft tissue sarcoma originating from smooth muscle. We evaluated the clinical course and treatment outcome of patients with metastatic leiomyosarcoma. Methods: We retrospectively reviewed the records of patients at the University Hospitals Leuven. Results: We identified 122 patients with metastatic leiomyosarcoma, 77 female, median age 59.5 years. Most patients developed leiomyosarcoma in the extremities (35%), the uterus (20%) or the abdomen (19%); 69% developed metachronous metastasis, 31% had synchronous metastatic disease. Most patients (74%) received palliative systemic therapy. The most common first-line treatments were doxorubicin (n = 47) and an anthracycline combined with an alkylator (n = 28). The objective response rate to first-line palliative systemic therapy was 20% and the median progression-free survival was 4.9 months (range 0.1-17.1). The median survival from diagnosis of metastasis was 20.5 months (range 0.4-126.9). On multivariate analysis, metachronous disease, no progressive disease as best response to first-line treatment, the possibility of metastasectomy with curative intent and use of palliative radiotherapy were indicators for better survival. Conclusion: The prognosis of patients with metastatic leiomyosarcoma is limited and objective responses to first-line systemic therapy are rare. The treatment of metastatic leiomyosarcoma remains an unmet medical need.

Metastatic Soft Tissue Sarcomas in Adolescents and Young Adults: A Specialist Center Experience

“…Previous studies have reported no significant differences in the outcomes of patients with advanced or metastatic uterine leiomyosarcoma (uLMS) versus non-uLMS. [28][29][30] Survival of AYAs with metastatic synovial sarcoma was similar to that of adults with synovial sarcoma in the French Sarcoma Group ''METASARC'' observational study (AYAs: 19.5 months vs. adults: 19.7 months). 31 Others have reported a better prognosis for AYAs with metastatic synovial sarcoma compared with that for adults .32,33 Despite similar histological features, characteristic t(X;18) translocation, and fusion transcripts, adults with synovial sarcoma have worse outcomes compared to children with synovial sarcoma.…”

Surgery plus chemotherapy improves survival of patients with extremity soft tissue leiomyosarcoma and metastasis at presentation

“…Harati et al 14 also found that radiation did not significantly improve local recurrence-free survival, disease-specific survival in somatic LMS. However, van Cann et al 32 reported that metastatic LMS patients undergoing radiation treatment had significant better survival compared to patients not undergoing this treatment. Thus, prospective trials are urgently required for further confirmation.…”

Pankreatomia jako forma leczenia przerzutu mięśniakomięsaka gładkokomórkowego- opis przypadku i przegląd literatury

“…Other cancers that metastasise to this organ relatively often are colorectal cancer, melanoma, sarcomas [7]. The prognosis for patients with pancreatic leiomyosarcoma metastasis is unknown, although metastatic sarcoma usually indicates poor prognosis, where the average survival time is between 10-30 months [2]. Metastases can occur as a single neoplastic changes or disseminated lesions.…”

“…For primary leiomyosarcoma, the treatment of choice is tumor resection, which can be combined with adjuvant chemotherapy or radiotherapy. About 40% of these cases metastasise, which is associated with poor prognosis [2]. Secondary lesions, usually disseminated, are treated with systemic chemotherapy.…”