Somatic Leiomyosarcoma of the Soft Tissues: A Single‐Institutional Analysis of Factors Predictive of Survival in 164 Patients

Harati, Kamran; Daigeler, Adrien; Lange, Katrin; Niggemann, Hiltrud; Stricker, Ingo; Steinau, Hans-Ulrich; Lehnhardt, Marcus; Goertz, Ole

doi:10.1007/s00268-017-3899-5

Cited by 22 publications

(35 citation statements)

References 42 publications

(56 reference statements)

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“…One possible reason for this may be that older patients are more likely to have metastases. High histological grade has been identified as an indicator of a poor prognosis in somatic LMS (1, 7), consistent with our results. Despite intensive treatment, patients with extremity soft tissue sarcoma and metastasis usually have poor prognosis (1, 7, 27).…”

Section: Discussionsupporting

confidence: 92%

“…Data extracted from the SEER database included age, gender, year of diagnosis, location, tumor grade, tumor stage, tumor size, surgical treatment, radiation treatment, cause of death, and survival time. Patient age of 60 was chosen as a cutoff because it was an indicator of older patients and a negative factor of survival (1, 13). Surgery or radiation treatment for tumors in our study refers to treatment for local primary tumors.…”

Section: Methodsmentioning

confidence: 99%

“…Soft tissue leiomyosarcoma (LMS) is an aggressive sarcoma, which originates from smooth muscle cells (1). Soft tissue LMS accounts for about 5–10% of all soft tissue sarcomas (2).…”

Section: Introductionmentioning

confidence: 99%

“…Extremity LMS comprised about 10–15% of extremity sarcomas, with a preference for the lower limb (4–6). Extremity LMS tends to have a better prognosis than uterine, retroperitoneal, or major vessel LMS (1, 7), but worse overall survival (OS) than other soft tissue sarcoma subtypes (8). Moreover, patients with metastasis usually have a poorer prognosis (2, 9, 10).…”

Section: Introductionmentioning

confidence: 99%

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Development and Validation of a Prognostic Nomogram for Extremity Soft Tissue Leiomyosarcoma

et al. 2019

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Background: Extremity soft tissue leiomyosarcoma (LMS) is a rare disease with a poor prognosis. The aim of this study is to develop nomograms to predict the overall survival (OS) and cancer-specific survival (CSS) of patients with extremity soft tissue LMS. Methods: Based on the Surveillance, Epidemiology, and End Results (SEER) database, 1,528 cases of extremity soft tissue LMS diagnosed between 1983 and 2015 were included. Cox proportional hazards regression modeling was used to analyze prognosis and obtain independent predictors. The independent predictors were integrated to develop nomograms predicting 5- and 10-year OS and CSS. Nomogram performance was evaluated by a concordance index (C-index) and calibration plots using R software version 3.5.0. Results: Multivariate analysis revealed that age ≥60 years, high tumor grade, distant metastasis, tumor size ≥5 cm, and lack of surgery were significantly associated with decreased OS and CSS. These five predictors were used to construct nomograms for predicting 5- and 10-year OS and CSS. Internal and external calibration plots for the probability of 5- and 10-year OS and CSS showed excellent agreement between nomogram prediction and observed outcomes. The C-index values for internal validation of OS and CSS prediction were 0.776 (95% CI 0.752–0.801) and 0.835 (95% CI 0.810–0.860), respectively, whereas those for external validation were 0.748 (95% CI 0.721–0.775) and 0.814 (95% CI 0.785–0.843), respectively. Conclusions: The proposed nomogram is a reliable and robust tool for accurate prognostic prediction in patients with extremity soft tissue LMS.

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Section: Discussionsupporting

confidence: 92%

Section: Methodsmentioning

confidence: 99%

“…Soft tissue leiomyosarcoma (LMS) is an aggressive sarcoma, which originates from smooth muscle cells (1). Soft tissue LMS accounts for about 5–10% of all soft tissue sarcomas (2).…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Development and Validation of a Prognostic Nomogram for Extremity Soft Tissue Leiomyosarcoma

et al. 2019

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“…Leiomyosarcoma (LMS) is a rare sarcoma of soft tissue that arises from smooth muscle cells and can occur anywhere in the body. On the basis of the location of the tumor, LMS is classified into uterine, lung, vascular, cutaneous, bladder, somatic, gastrointestinal, and limbs subsets. These subtypes of LMS present with various clinical behaviors and rate of survival.…”

mentioning

confidence: 99%

Nomograms Predict Cancer‐Specific and Overall Survival of Patients With Primary Limb Leiomyosarcoma

Wang

Hong

Meng

et al. 2019

Journal Orthopaedic Research

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To date, there have been no data to predict the survival of patients with leiomyosarcoma from soft limb tissue because of the rarity of this disease. Nomograms have been widely applied in clinical oncology to precisely predict the survival of individual patients. This was a retrospective study to construct and validate nomograms to predict the cancer-specific survival (CSS) and overall survival (OS) of patients with primary limb leiomyosarcoma (PL-LMS). A total of 1,208 patients with LMS from limb soft tissue were collected from the Surveillance, Epidemiology, and End Results database from 1975 to 2015. We identified independent prognostic factors using univariate and multivariate Cox analyses. These prognostic factors were then included in the nomograms to predict 3-and 5-year CSS and OS rates. Finally, we validated the nomograms internally and externally. A total of 1208 patients were collected and divided into validation (N = 604) and training (N = 604) groups. Age, race, grade, tumor size, stage, and surgical types were demonstrated as independent prognostic factors for CSS and OS (all p < 0.05) and further used to construct the nomograms. The concordance index (C-index) for CSS was 0.857 for internal validation and 0.727 for external validation. The C-index for OS and CSS both demonstrated that the nomogram prediction agreed perfectly with actual survival. We developed nomograms to predict CSS and OS in PL-LMS patients and can benefit from using them to identify patients' mortality risk and make more precise assessments regarding survival.

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Comparison of clinicopathological features and outcomes in patients with primary leiomyosarcoma of bone and soft tissue

Gusho

Blank

Gitelis

2021

Journal of Surgical Oncology

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Backgrounds and Objectives This investigation sought to describe the outcomes of primary leiomyosarcoma of bone (PLB) compared to soft tissue leiomyosarcoma (SLMS). Methods This was a review of the Surveillance, Epidemiology, and End Results database from 1975 to 2016. Kaplan‐Meier methods were used to estimate disease‐specific survival (DSS), and a Cox regression model was used to identify prognostic factors. Results Of the 7502 identifiable cases, 1% (n = 74) were PLB and 99% (n = 7428) were SLMS. Survival was the same between PLB and SLMS (p = .209). On multivariable analysis for high‐grade SLMS, radiation (neoadjuvant: hazard ratio [HR], 0.56; 95% confidence interval [CI], 0.4–0.8; p = .003; adjuvant: HR, 0.75; 95% CI, 0.6–0.9; p = .008) and surgery (procedure specific) improved DSS. For PLB, wide resection/limb salvage (HR, 0.40; 95% CI, 0.3–0.5; p = .018) and amputation (HR, 0.69; 95% CI, 0.5–0.9; p < .001) were positive prognostic factors. Neither radiation nor chemotherapy were prognostic factors for survival in PLB. Conclusions For SLMS, radiation portends a survival advantage. For PLB, however, neither chemotherapy nor radiation were significant prognostic factors, which suggests the optimal treatment for PLB, similar to other primary soft tissue sarcomas originating in bone, remains an unmet medical need.

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Somatic Leiomyosarcoma of the Soft Tissues: A Single‐Institutional Analysis of Factors Predictive of Survival in 164 Patients

Abstract: The data from this study could not determine a prognostic significance of surgical margins suggesting that tumour characteristics other than margin status are important. Tumour biology reflected by the histologic grade dictates the final outcome.

Cited by 22 publications

References 42 publications

Development and Validation of a Prognostic Nomogram for Extremity Soft Tissue Leiomyosarcoma

Development and Validation of a Prognostic Nomogram for Extremity Soft Tissue Leiomyosarcoma

Nomograms Predict Cancer‐Specific and Overall Survival of Patients With Primary Limb Leiomyosarcoma

Comparison of clinicopathological features and outcomes in patients with primary leiomyosarcoma of bone and soft tissue

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