Uterine sarcoma Part I-Uterine leiomyosarcoma: The Topic Advisory Group systematic review (original) (raw)
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Uterine sarcoma: prognostic factors and treatment evaluation
The Israel Medical Association journal : IMAJ, 2011
Uterine sarcoma constitutes a highly malignant group of uterine tumors. It accounts for 2-6% of uterine malignancies and its incidence is 1.7 in 100,000 women. The three most common variants of uterine sarcoma are endometrial stromal sarcoma, leiomyosarcoma and carcinosarcoma. Based on relatively small case series, the literature provides little information on the risk factors, the natural course of the disease and the preferred treatment. To evaluate uterine sarcoma patients treated in a tertiary referral center in Israel over a 20 year period (1980-2005). We conducted a retrospective review of the charts of 40 uterine sarcoma patients, including their tumor characteristics, stage at diagnosis, treatment modalities, follow-up and survival. The patients' mean age was 53 years (range 32-76); 30% of the patients had carcinosarcoma, 55% had leiomyosarcoma and 15% had ESS. Half of the patients presented with stage I disease, 23% stage II, 10% stage III and 15% stage IV. Thirty-nine ...
Uterine leiomyosarcomas: a review of the diagnostic and therapeutic pitfalls
The Obstetrician & Gynaecologist, 2007
• Uterine leiomyosarcomas are the most common uterine sarcoma and they are notoriously aggressive in nature. • Preoperative diagnosis is difficult and they are usually detected as an incidental finding at surgery. • Tumour stage is the most important prognostic factor. • Misdiagnosis or delay in diagnosis can occur following the use of conservative techniques for managing uterine fibroids. • The primary treatment is surgical, while the role of adjuvant therapy is still to be clearly defined. Learning objectives: • To appreciate the diagnostic challenges faced with uterine leiomyosarcomas, especially in view of the similarities with uterine fibroids. • To learn about the current views on surgical treatment and adjuvant therapy. • To have an understanding of the novel therapies currently under investigation. Ethical issues: • Can we offer women conservative non-surgical treatment for fibroids if we cannot confidently exclude leiomyosarcomas?
Uterine Sarcomas: A Retrospective Analysis of a Cohort of 62 Patients
Cureus, 2021
Background and objective Uterine sarcomas are rare tumors, and they account for 4% of all uterine malignancies. These tumors are characterized by a great diversity of histological types, and current knowledge regarding their treatment is limited. The aim of our study was to analyze a cohort of patients with uterine sarcomas with respect to the histological types of their tumors, as well as their prognosis and treatment. Materials and methods This was a retrospective analysis involving patients diagnosed at a single center with uterine sarcoma between 2003 and 2017. Results The study included 62 patients; the mean age of the patients was 62 ±13 years. Carcinosarcoma was identified in 44% of cases, leiomyosarcoma in 40%, and endometrial stromal sarcoma in 13%. Endometrial stromal sarcoma was found to occur in younger women compared to carcinosarcoma (52 ±13 vs. 66 ±12 years, p=0.016); 90% of patients underwent surgery, and medical treatment was implemented in 42%. The mean overall sur...
UTERINE LEIOMYOSARCOMA: About 13 Cases and Review of the Literature
Journal of medical biomedical and applied sciences, 2018
The uterine leiomyosarcoma (LMS) is a rare cancer arising from the smooth myometrial cells. The LMS is clinically aggressive malignancy, accounting for 2% to 6% of uterine malignancies and a very low annual incidence. Object of the study: To evaluate management and outcome of the treatment of uterine leiomyosarcoma. Patients and methods: Retrospective study of a series of 13 patients treated for uterine leiomyosarcoma in the department of radiotherapy of CHU Hassan II, Fes between 2012 and 2016 Results: The condition is rarely suspected preoperatively, diagnosis is usually made on histological examination of the operative specimen. The outcome is related to the mitotic activity of the tumour and to the infiltration of nearly structures. Surgery is the only effective treatment, chemotherapy is ineffective, adjuvant radiotherapy improves local control of the tumour but has no incidence on survival. Conclusion: In the absence of an effective adjuvant treatment, uterine leiomyosarcoma bears a poor prognosis with the only exception of small non infiltring tumours with a low mitotic activity.
Uterine leiomyosarcoma: A case report
Journal of Mid-life Health, 2014
Uterine leiomyosarcoma is a rare uterine malignancy that arises from the smooth muscles of uterine wall. It accounts for only 1-2% of uterine malignancies. We report a case of a 60-year-old female who presented with postmenopausal bleeding and was diagnosed later to be a case of leiomyosarcoma of uterus. The diagnosis of leiomyosarcoma is made by histopathological examination, and surgery is the only treatment. The prognosis for female with uterine sarcoma primarily depends on the extent of disease at the time of diagnosis and the mitotic index.
The uterine leiomyosarcoma (LMS) is a rare sarcoma arising from the smooth muscle cells found within the myometrium, it is clinically aggressive smooth muscle malignancy, accounting for 2% to 6% of uterine malignancies and an annual incidence of 1.7 per 100,000 women. Although uterine malignancies such as endometrial cancer are common, uterine LMS accounts for only 1% of uterine cancers and is a part of uterine sarcomas' group, who comprises: carcinosarcoma (formerly known as MMMT, malignant mixed Mullerian tumor) (40% to 50%), leiomyosarcoma (30% to 40%) and endometrial stromal sarcoma (10% to 15%). Every group has its own risk factors, presenting symptoms, treatment response and prognosis. 1 Uterine smooth muscle tumors arise from the uterine myometrium and include leiomyomas (or fibroids) and uterine LMS, who exhibits histological features similar to that observed in soft tissue leiomyosarcomas. In fact, smooth muscle cell tumours may be divided into three groups: benign (leiomyoma), malignant (leiomyosarcoma), and tumors of unknown malignant potential. 2
Prognostic Factors in Early-Stage Leiomyosarcoma of the Uterus
International Journal of Gynecologic Cancer, 2009
Uterine leiomyosarcomas (LMSs) are rare cancers representing less than 1% of all uterine malignancies. Clinical International Federation of Gynecology and Obstetrics (FIGO) stage is the most important prognostic factor. Other significant prognostic factors, especially for early stages, are difficult to establish because most of the published studies have included localized and extra-pelvian sarcomas. The aim of our study was to search for significant prognostic factors in clinical stage I and II uterine LMS. The pathologic features of 108 uterine LMS including 72 stage I and II lesions were reviewed using standardized criteria. The prognostic significance of different pathologic features was assessed. The median follow-up in the whole group was 64 months (range, 6-223 months). The 5-year overall survival (OS) and metastasis-free interval and local relapse-free interval rates in the whole group and early-stage group (FIGO stages I and II) were 40% and 57%, 42% and 50%, 56% and 62%, r...
Uterine leiomyosarcoma in a premenopausal woman Clinical case 1
American Journal of Medical and Clinical Research & Reviews, 2023
INTRODUCTION. Leiomyosarcoma (LMS) of the uterus is a rare soft-tissue tumor of the female pelvis with <1% of uterine tumor. It usually arises from the uterine myometrium de novo or is very rarely transformed from a preexisting benign leiomyoma. These tumors are found mainly in females 40-60 years of age. Leiomyomas seen in the reproductive age group and a strong suspicion of LMS should be in mind in cases of fibroid with postmenopausal bleeding. CLINICAL CASE. A 39-year-old female came to the emergency room complaining of pelvic pain of 8 days duration, treated symptomatically with NSAIDs. It has the following background: hereditary family history, which is unimportant to the case. Gynecobstetric history: menarche 11 years old, regular cycles five to seven days, reports two months with uncontrolled cycle with heavy menstrual bleeding, start active sexual life 24 years old. Papanicolaou: last year reported normal; colposcopy last one and a half ago reported normal. DISCUSSION. Approximately 40-80% of women may develop leiomyomas, the most common benign gynecological disease, during their lifetime. Uterine sarcoma, on the other hand, is a rare disease with an incidence ranging from 1.55 to 1.95 per 100,000 women per year. According to the WHO, in 2011, a LMS is a specific type of rare sarcoma that accounts for over 60% of all cases of uterine sarcoma. It is
Uterine sarcoma: Clinico-pathological characteristics and outcome
Saudi Medical Journal, 2014
Objectives: To investigate the clinical and histopathological characteristics, with the prognostic factors, treatment outcome, pattern of relapse, and survival analysis of uterine sarcoma patients. Methods: All patients with histologically proven uterine sarcoma were identified using the database at King Abdulaziz University Hospital, Jeddah, Saudi Arabia between January 2000 and December 2012. Results: A total of 36 patients with uterine sarcoma were reviewed. The median age of all patients was 57 years, and the mean age was 57.72+/-13.17 years. Carcinosarcoma was reported in 21 patients (58%), leiomyosarcoma in 7 (19%), undifferentiated endometrial sarcoma in 6 (17%), and rhabdomyosarcoma in 2 (6%). Approximately half of the patients were stages III and IV (28% and 25%), while 15 patients (41%) were stage I; only 2 patients (6%) were stage II. The surgical treatment was hysterectomy and bilateral salpingoophorectomy (H+BSO) plus staging in 18 patients (50%), while in 4 patients (1...
Diagnosis, treatment and survival of uterine sarcoma: A retrospective cohort study of 122 cases
Molecular and Clinical Oncology, 2020
The present study aimed to assess the diagnosis, treatment and follow-up of uterine sarcoma cases. A retrospective cohort study with 122 women recruited between 2001 and 2016 was performed. The data regarding epidemiology, clinical presentation, treatment and follow-up were analyzed based on the following histological types: Carcinosarcoma, leiomyosarcoma, endometrial stromal sarcoma (ESS) and adenosarcoma. Statistical analysis included descriptive statistics, logistic regression and survival curves. The diagnosis of uterine sarcoma exhibited an increasing trend of +1.2 new cases every 2 years (P=0.044) and comprised 10% of all uterine cancer diagnoses. There were 47% carcinosarcomas, 22% leiomyosarcomas, 16% ESS and 14% adenosarcomas. The majority of the women was ≥60 years old (62%). Among the subjects, 77% were postmenopausal, 61% had a body mass index up to 29.9 kg/m 2 and 71% presented with a comorbidity. Regression analysis exhibited an association between post menopause and the histological type associated with lower overall survival (OS), namely leiomyosarcoma or carcinosarcoma (odds ratio, 5.45, P<0.001). Stage I malignancy was present in 44% and Stage IV in 22%. The treatment included primary surgery in 78% of the cases, whereas 79% received adjuvant therapy. Only 55 cases achieved disease control and 20 relapsed (36%) with a 5-year OS rate of 33%. The OS was lower for carcinosarcoma and leiomyosarcoma (20%; P=0.003). In summary, the present study indicated that the number of uterine sarcoma cases had increased between 2001 and 2016. The majority of the women were >60 years old and diagnosed in advanced stages. The postmenopausal status was associated with histological types of poor prognosis. The OS was low and worse for patients with carcinosarcoma and leiomyosarcoma.