Trends in the Treatment of Uterine Leiomyosarcoma in the Medicare Population

Foley, Olivia W.; Rauh‐Hain, J. Alejandro; Clemmer, Joel; Clark, Rachel M.; Hall, T.R.; Diver, Elisabeth; Schorge, John O.; Carmen, Marcela G. del

doi:10.1097/igc.0000000000000372

Cited by 20 publications

(8 citation statements)

References 26 publications

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“…1,2 Although rare, LMS tumors are associated with a very poor prognosis, and even in the setting of early-stage disease, these tumors tend to recur. Recurrence rates range from 53% to 71% 3 and are often extrapelvic.…”

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confidence: 99%

Gemcitabine and Docetaxel Compared With Observation, Radiation, or Other Chemotherapy Regimens as Adjuvant Treatment for Stage I-to-IV Uterine Leiomyosarcoma

Roque

Taylor

Palisoul

et al. 2016

International Journal of Gynecological Cancer

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confidence: 99%

Gemcitabine and Docetaxel Compared With Observation, Radiation, or Other Chemotherapy Regimens as Adjuvant Treatment for Stage I-to-IV Uterine Leiomyosarcoma

Roque

Taylor

Palisoul

et al. 2016

International Journal of Gynecological Cancer

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“…However, sex, primary site, laterality, and year of diagnosis were not related to the OS and CSS of PL‐LMS patients via multivariate analysis. A possible explanation for the negative relationship between year of diagnosis and OS/CSS was that chemotherapy and radiotherapy use in this population did not seem to offer a survival benefit …”

Section: Discussionmentioning

confidence: 90%

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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“…Uterine leiomyosarcoma (LMS) is a rare uterine cancer that accounts for approximately 1% of all uterine cancers [12]. However, because of its aggressive biology and resistance to chemotherapy, LMS causes approximately 70% of deaths caused by uterine malignant tumors [34]. The symptoms and presenting characteristics of uterine LMS are almost indistinguishable from those of uterine leiomyoma [1].…”

Section: Introductionmentioning

confidence: 99%

“…Recently, there has been an increase in the frequency of adjuvant chemotherapy and radiation therapy for the treatment of uterine LMS. However, adjuvant treatment has not shown a definite survival advantage [3].…”

Section: Introductionmentioning

confidence: 99%

Prognostic factors for recurrence and survival in uterine leiomyosarcoma: Korean single center experience with 50 cases

et al. 2019

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ObjectiveThe aim of this study was to determine the possible prognostic factors in patients with uterine leiomyosarcoma (LMS).MethodsThis study retrospectively investigated 50 patients with uterine LMS treated at the Samsung Medical Center between 2001 and 2017. To analyze the prognostic significance of factors for recurrence-free survival (RFS), overall survival (OS), and survival after recurrence, the log-rank test and Cox proportional hazards model were used for univariate and multivariate analysis.ResultsOf the 50 patients, 30 (60.0%) experienced recurrence and 16 (32.0%) died within a median follow-up period of 21 (range, 3–99) months. Multivariate analysis revealed that older age, absence of residual tumor after surgery, lower mitotic count, and a history of adjuvant radiotherapy at first treatment were significantly associated with better RFS. Presence of residual tumor after surgery and severe nuclear atypia were associated with poor OS. In the analysis of survival after recurrence, hematogenous recurrence, severe nuclear atypia, and presence of residual tumor at primary surgery were significantly associated with worse prognosis. Notably, residual tumor status at primary surgery was associated with RFS, OS, and survival after recurrence.ConclusionWe demonstrated the possible prognostic factors for RFS, OS, and survival after recurrence for patients with LMS. These results may provide useful information for patients with LMS.

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Trends in the Treatment of Uterine Leiomyosarcoma in the Medicare Population

Cited by 20 publications

References 26 publications

Gemcitabine and Docetaxel Compared With Observation, Radiation, or Other Chemotherapy Regimens as Adjuvant Treatment for Stage I-to-IV Uterine Leiomyosarcoma

Gemcitabine and Docetaxel Compared With Observation, Radiation, or Other Chemotherapy Regimens as Adjuvant Treatment for Stage I-to-IV Uterine Leiomyosarcoma

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

Prognostic factors for recurrence and survival in uterine leiomyosarcoma: Korean single center experience with 50 cases

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