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

Abstract

Purpose : Extremity soft tissue leiomyosarcoma (LMS) with metastasis is a rare disease with a poor prognosis. The purpose of our study was to define clinical features of extremity soft tissue LMS with metastasis as well as to identify multivariable predictors of survival. Methods : During 1973-2015, 239 patients with metastatic extremity soft tissue LMS were identified from the Surveillance, Epidemiology, and End Results (SEER) program database. The prognostic analysis was performed using the Kaplan-Meier method and a Cox proportional hazards regression model. Results : This group comprised 126 females (52.7%) and 113 males (47.3%), whose ages ranged from 8 to 95 years (median 67 years). The overall survival (OS) and cancer-specific survival (CSS) rates of the entire group at 3 years were 22.6% and 23.4%, respectively. The median OS and CSS were 14.0±1.5 and 15.0±2.3 months, respectively. Multivariate analysis revealed that tumor size >10 cm, no surgery and no chemotherapy were independent risk factors of decreased OS and CSS. Radiotherapy was not significantly associated with OS or CSS. Conclusion : Extremity soft tissue LMS patients who present with metastasis at diagnosis had a poor prognosis. Patients who performed surgery for primary tumors and chemotherapy had a better chance for prolonged survival.

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

“…These results seem to align with the current literature detailing the aggressive nature of leiomyosarcoma, namely SLMS 5,15,16,18,19 . However, very few data describe the tumor characteristics of PLB, nor do they identify very many prognostic factors as these studies are mostly limited to case reports and small series 4,5,14,17,20–25 . Among the available literature for PLB, high histologic grade and tumor stage have demonstrated an association with distant metastases and local recurrence following surgical resection 22,26 .…”

“…Mestiri et al published the results of 29 consecutive cases of histologically proven SLMS, and in addition to high rates of local recurrence (55%) and initial metastases, they note the majority of patients (69%) underwent surgery, and they suggest surgery appears to be the cornerstone of treatment for SLMS 13 . More recently, Qian et al 4 found surgery and chemotherapy together improved survival in patients with SLMS and metastases at presentation. Last, in their study of 7154 leiomyosarcoma patients, Gootee et al 16 demonstrated a lower risk of mortality in patients treated surgically with adjuvant radiation.…”

“…For SLMS, the optimal treatment has been explored though clear guidelines are lacking. According to the literature on the management of SLMS, surgery appears to lower the mortality risk compared no surgical intervention 4,5 . Additional studies also describe the benefit of multimodal therapy, though the true role of surgery with radiation and/or chemotherapy is yet to be elucidated 6,7 .…”

Recurrent broad ligament leiomyosarcoma with pancreatic and thigh metastasis: a case report

“…Treatment of metastatic LMS involves a multi-strategy in stepwise management, such as surgery, systemic treatment and radiotherapy [4]. Qian et al [21] analyzed data of 239 patients with metastatic extremity LMS, and found that surgery plus chemotherapy improved survival of these patients. However, in this case, radiotherapy and chemotherapy all failed.…”

Clinicopathological Characteristics and Prognosis in Endometrial Cancer With Bone Metastasis: A SEER-Based Study of 584 Women

“…We completed all statistical analyses by IBM SPSS Statistics 22. We defined cancer-specific survival (CSS) as the interval from diagnosis till death due to EC ( 10 , 11 ). We used the univariable Cox regression model to screen for statistically significant indicators associated with OS and CSS.…”