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

다국어 초록 (Multilingual Abstract)

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 between2001 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 andmultivariate 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, lowermitotic 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 ofsurvival after recurrence, hematogenous recurrence, severe nuclear atypia, and presence of residual tumor at primarysurgery were significantly associated with worse prognosis. Notably, residual tumor status at primary surgery wasassociated 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.

참고문헌 (Reference)

1 Kempson RL, "Uterine sarcomas. Classification, diagnosis, and prognosis" 1 : 331-349, 1970

2 Abeler VM, "Uterine sarcomas in Norway. A histopathological and prognostic survey of a total population from 1970 to 2000 including 419 patients" 54 : 355-364, 2009

3 D’Angelo E, "Uterine sarcomas : a review" 116 : 131-139, 2010

4 Schwartz Z, "Uterine sarcoma in Israel : a study of 104 cases" 20 : 354-363, 1985

5 Hosh M, "Uterine sarcoma : analysis of 13, 089 cases based on Surveillance, Epidemiology, and End Results Database" 26 : 1098-1104, 2016

6 Greer BE, "Uterine neoplasms. Clinical practice guidelines in oncology" 7 : 498-531, 2009

7 김우영, "Uterine Leiomyosarcoma : 14-year Two-center Experience of 31 Cases" 대한암학회 41 (41): 24-28, 2009

8 Foley OW, "Trends in the treatment of uterine leiomyosarcoma in the Medicare population" 25 : 453-458, 2015

9 Dinh TA, "The treatment of uterine leiomyosarcoma. Results from a 10-year experience (1990–1999) at the Massachusetts General Hospital" 92 : 648-652, 2004

10 Felix AS, "The etiology of uterine sarcomas : a pooled an]alysis of the epidemiology of endometrial cancer consortium" 108 : 727-734, 2013

11 Leitao MM, "Surgical resection of pulmonary and extrapulmonary recurrences of uterine leiomyosarcoma" 87 : 287-294, 2002

12 Leitao MM Jr, "Surgical cytoreduction in patients with metastatic uterine leiomyosarcoma at the time of initial diagnosis" 125 : 409-413, 2012

13 Anderson TM, "Pulmonary resection in metastatic uterine and cervical malignancies" 83 : 472-476, 2001

14 백이선, "Pulmonary metastasectomy in uterine malignancy: outcomes and prognostic factors" 대한부인종양학회 26 (26): 270-276, 2015

15 Pelmus M, "Prognostic factors in early-stage leiomyosarcoma of the uterus" 19 : 385-390, 2009

16 Kapp DS, "Prognostic factors and survival in 1396 patients with uterine leiomyosarcomas:emphasis on impact of lymphadenectomy and oophorectomy" 112 : 820-830, 2008

17 Seagle BL, "Prognosis and treatment of uterine leiomyosarcoma : a National Cancer Database study" 145 : 61-70, 2017

18 Mayerhofer K, "Leiomyosarcoma of the uterus : a clinicopathologic multicenter study of 71 cases" 74 : 196-201, 1999

19 Leibsohn S, "Leiomyosarcoma in a series of hysterectomies performed for presumed uterine leiomyomas" 162 : 968-974, 1990

20 Toro JR, "Incidence patterns of soft tissue sarcomas, regardless of primary site, in the surveillance, epidemiology and end results program, 1978–2001 : an analysis of 26, 758cases" 119 : 2922-2930, 2006

21 Leitao MM, "Incidence of lymph node and ovarian metastases in leiomyosarcoma of the uterus" 91 : 209-212, 2003

22 Clavero JM, "Gynecologic cancers : factors affecting survival after pulmonary metastasectomy" 81 : 2004-2007, 2006

23 Prat J, "FIGO staging for uterine sarcomas" 104 : 177-178, 2009

24 Nishigaya Y, "Diagnostic value of combination serum assay of lactate dehydrogenase, D-dimer, and C-reactive protein for uterine leiomyosarcoma" 45 : 189-194, 2019

25 Menczer J, "CA125 expression in the tissue of uterine leiomyosarcoma" 16 : 697-699, 2014

26 Hosmer DW Jr, "Applied logistic regression" John Wiley &Sons 2013

27 Zivanovic O, "A nomogram to predict postresection 5-year overall survival for patients with uterine leiomyosarcoma" 118 : 660-669, 2012