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Leiomyosarcoma: One disease or distinct biologic entities based on site of origin?
Author(s) -
Worhunsky David J.,
Gupta Mihir,
Gholami Sepideh,
Tran Thuy B.,
Ganjoo Kristen N.,
van de Rijn Matt,
Visser Brendan C.,
Norton Jeffrey A.,
Poultsides George A.
Publication year - 2015
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23904
Subject(s) - medicine , leiomyosarcoma , proportional hazards model , trunk , disease , uterus , overall survival , survival analysis , surgery , radiology , oncology , ecology , biology
Background Leiomyosarcoma (LMS) can originate from the retroperitoneum, uterus, extremity, and trunk. It is unclear whether tumors of different origin represent discrete entities. We compared clinicopathologic features and outcomes following surgical resection of LMS stratified by site of origin. Methods : Patients with LMS undergoing resection at a single institution were retrospectively reviewed. Clinicopathologic variables were compared across sites. Survival was calculated using the Kaplan–Meier method and compared using log‐rank and Cox regression analyses. Results From 1983 to 2011, 138 patients underwent surgical resection for LMS. Retroperitoneal and uterine LMS were larger, higher grade, and more commonly associated with synchronous metastases. However, disease‐specific survival, recurrence‐free survival, and recurrence patterns were not significantly different across the four sites. Synchronous metastases (HR 3.20, P < 0.001), but not site of origin, size, grade, or margin status, were independently associated with worse DSS. A significant number of recurrences and disease‐related deaths were noted beyond 5 years. Conclusions Although larger and higher grade, retroperitoneal and uterine LMS share similar survival and recurrence patterns with their trunk and extremity counterparts. LMS of various anatomic sites may not represent distinct disease processes based on clinical outcomes. The presence of metastatic disease remains the most important prognostic factor for LMS. J. Surg. Oncol. 2015 111:808–812 . © 2014 Wiley Periodicals, Inc.