Display options
Cite
Pellanda AF, De Bari B, Deniaud-Alexandre E, et al. Outcome and prognostic factors in 110 consecutive patients with primary uterine leiomyosarcoma: A Rare Cancer Network study. Chin J Cancer Res. 2017;29(6):521-532doi: 10.21147/j.issn.1000-9604.2017.06.06.
Pellanda, A. F., De Bari, B., Deniaud-Alexandre, E., Krengli, M., Van Houtte, P., Richetti, A., Villà, S., Goldberg, H., Szutowicz-Zielińska, E., Bolla, M., Rutten, H., Van Eijkeren, M., Poortmans, P., Henke, G., Anacak, Y., Chan, S., Landmann, C., Kirkove, C., Scandolaro, L., Bernier, J., Mirimanoff, R. O., & Ozsahin, M. (2017). Outcome and prognostic factors in 110 consecutive patients with primary uterine leiomyosarcoma: A Rare Cancer Network study. Chinese journal of cancer research = Chung-kuo yen cheng yen chiu, 29(6), 521-532. https://doi.org/10.21147/j.issn.1000-9604.2017.06.06
Pellanda, Alessandra Franzetti, et al. "Outcome and prognostic factors in 110 consecutive patients with primary uterine leiomyosarcoma: A Rare Cancer Network study." Chinese journal of cancer research = Chung-kuo yen cheng yen chiu vol. 29,6 (2017): 521-532. doi: https://doi.org/10.21147/j.issn.1000-9604.2017.06.06
Pellanda AF, De Bari B, Deniaud-Alexandre E, Krengli M, Van Houtte P, Richetti A, Villà S, Goldberg H, Szutowicz-Zielińska E, Bolla M, Rutten H, Van Eijkeren M, Poortmans P, Henke G, Anacak Y, Chan S, Landmann C, Kirkove C, Scandolaro L, Bernier J, Mirimanoff RO, Ozsahin M. Outcome and prognostic factors in 110 consecutive patients with primary uterine leiomyosarcoma: A Rare Cancer Network study. Chin J Cancer Res. 2017 Dec;29(6):521-532. doi: 10.21147/j.issn.1000-9604.2017.06.06. PMID: 29353974; PMCID: PMC5775016.
Copy Download .nbib Format: NLM
Share it on

Chin J Cancer Res. 2017 Dec;29(6):521-532. doi: 10.21147/j.issn.1000-9604.2017.06.06.

Outcome and prognostic factors in 110 consecutive patients with primary uterine leiomyosarcoma: A Rare Cancer Network study.

Chinese journal of cancer research = Chung-kuo yen cheng yen chiu

Alessandra Franzetti Pellanda, Berardino De Bari, Elisabeth Deniaud-Alexandre, Marco Krengli, Paul Van Houtte, Antonella Richetti, Salvador Villà, Hadassah Goldberg, Ewa Szutowicz-Zielińska, Michel Bolla, Heidi Rutten, Marc Van Eijkeren, Philip Poortmans, Guido Henke, Yavuz Anacak, Steve Chan, Christine Landmann, Carine Kirkove, Luciano Scandolaro, Jacques Bernier, René-Olivier Mirimanoff, Mahmut Ozsahin

Affiliations

  1. Centre Hospitalier Universitaire Vaudois (CHUV), 1011 Lausanne, Switzerland.
  2. Clinica Luganese Moncucco, 6903 Lugano, Switzerland.
  3. Centre Hospitalier Régional Universitaire "Jean Minjoz", INSERM, UMR1098, 25030 Besançon, France.
  4. Hôpital Tenon, 75970 Paris, France.
  5. Centre Hospitalier Départemental, 85925 Vendee, France.
  6. Università degli Studi del Piemonte Orientale e Ospedale Maggiore della Carità, 28100 Novara, Italy.
  7. Institut Jules Bordet, 1000 Brussels, Belgium.
  8. Ospedale di Circolo, 21100 Varese, Italy.
  9. Istituto Oncologico della Svizzera Italiana, EOC, 6500 Bellinzona, Switzerland.
  10. Catalan Institute of Oncology, Universitat Autònoma de Barcelona, 08916 Barcelona 08916, Spain.
  11. Rambam Medical Center, 31096 Haifa, Israel.
  12. Medical University, 80210 Gdansk, Poland.
  13. Hôpital Michallon, BP217, 38043, Grenoble cedex 09, France.
  14. Radboud University Medical Center, 6525 Nijmegen, The Netherlands.
  15. Ghent University Hospital, 9000 Gent, Belgium.
  16. Institute Verbeeten, 90120 Tilburg, The Netherlands.
  17. Kantonsspital St. Gallen, 9007, St. Gallen, Switzerland.
  18. Karadeniz Technical University, 61080 Trabzon, Turkey.
  19. Nottingham University Hospital, NHS trust, NG5 1PB Nottingham, United Kingdom.
  20. Kantonsspital Basel, 4031 Basel, Switzerland.
  21. UCL St. Luc, 1200 Brussels, Belgium.
  22. Presidio Ospedaliero Sant'Anna, 22100 Como, Italy.
  23. Ospedale San Giovanni, 6500 Bellinzona, Switzerland.
  24. Clinique de Genolier, Genolier, 1272 Switzerland.

PMID: 29353974 PMCID: PMC5775016 DOI: 10.21147/j.issn.1000-9604.2017.06.06

Abstract

OBJECTIVE: Primary uterine leiomyosarcomas (ULMS) are rare, and the optimal treatment is controversial. We aimed to assess the outcome and prognostic factors in a multicenter population of women treated for primary ULMS.

METHODS: We retrospectively collected data of 110 women treated in 19 institutions of the Rare Cancer Network (RCN). Inclusion criteria consisted of a pathology report confirming the diagnosis of ULMS, aged 18-80 years, complete International Federation of Gynecology and Obstetrics (FIGO) stage information, complete information on treatment, and a minimum follow-up of 6 months. Local control (LC) and locoregional control (LRC), overall survival (OS) and disease-free survival (DFS) rates were computed using the Kaplan-Meier method. Univariate analysis was implemented using the log rank test, and multivariate analysis using the Cox model.

RESULTS: All patients underwent surgery. Seventy-five patients (68%) received adjuvant radiotherapy (RT), including brachytherapy in 18 (16%). Seventeen patients (15%) received adjuvant chemotherapy. Median follow-up was 58 (range, 6-240) months. Five-year OS and DFS rates were 50% and 34%, and LC and LRC rates were 88% and 72%, respectively. On multivariate analysis, independent favorable prognostic factors were younger age, FIGO stage I, small tumor size, previous uterine disease, and no vascular invasion for OS and DFS. FIGO stage was the only favorable factor influencing LRC. Adjuvant local or systemic treatments did not improve the outcomes. Eight patients treated with RT presented a grade 3 acute toxicity, and only one patient with grade 3 late toxicity.

CONCLUSIONS: In this large population of primary ULMS patients, we found good results in terms of LC and LRC. Nevertheless, OS remains poor, mainly due to the occurrence of distant metastases. An early diagnosis seemed to improve the prognosis of the patients. Adjuvant local or systemic treatments, or more aggressive surgical procedures such as the Wertheim procedure, did not seem to impact the outcome.

Keywords: Uterine leiomyosarcoma; local control; overall survival; prognostic factors; radiotherapy

References

  1. Gynecol Oncol. 2003 Jun;89(3):460-9 - PubMed
  2. Cancer. 2008 Feb 15;112(4):820-30 - PubMed
  3. J Clin Oncol. 1985 Sep;3(9):1240-5 - PubMed
  4. Int J Gynecol Cancer. 2016 Mar;26(3):456-63 - PubMed
  5. Int J Radiat Oncol Biol Phys. 2010 Mar 1;76(3):728-34 - PubMed
  6. Int J Gynecol Cancer. 2009 Aug;19(6):1080-4 - PubMed
  7. Expert Rev Anticancer Ther. 2016;16(1):45-55 - PubMed
  8. Cancer. 1993 Feb 15;71(4 Suppl):1702-9 - PubMed
  9. Control Clin Trials. 1996 Aug;17(4):343-6 - PubMed
  10. J BUON. 2010 Jul-Sep;15(3):480-8 - PubMed
  11. Rare Tumors. 2014 Aug 06;6(3):5462 - PubMed
  12. Br J Cancer. 1977 Jan;35(1):1-39 - PubMed
  13. Gynecol Oncol. 2007 Nov;107(2):177-85 - PubMed
  14. Int J Gynecol Cancer. 2016 Mar;26(3):505-11 - PubMed
  15. Cancer. 1990 Jul 1;66(1):35-9 - PubMed
  16. Gynecol Oncol. 1996 Jul;62(1):25-32 - PubMed
  17. Cancer Res Treat. 2009 Mar;41(1):24-8 - PubMed
  18. Int J Gynecol Cancer. 2009 Apr;19(3):385-90 - PubMed
  19. Gynecol Oncol. 1999 Aug;74(2):196-201 - PubMed
  20. Eur J Cancer. 2008 Apr;44(6):808-18 - PubMed
  21. Saudi Med J. 2014 Oct;35(10):1215-22 - PubMed
  22. J Egypt Natl Canc Inst. 2010 Jun;22(2):113-22 - PubMed
  23. Gynecol Oncol. 1998 Jan;68(1):54-61 - PubMed
  24. Cancer. 1988 Nov 15;62(10):2239-47 - PubMed
  25. Isr Med Assoc J. 2011 Feb;13(2):76-9 - PubMed
  26. Gynecol Oncol. 2016 Jul;142(1):89-94 - PubMed
  27. Int J Radiat Oncol Biol Phys. 2003 Dec 1;57(5):1366-73 - PubMed
  28. Gynecol Oncol. 1986 May;24(1):58-67 - PubMed
  29. Eur J Cancer. 1997 May;33(6):907-11 - PubMed
  30. Am J Surg Pathol. 2016 Mar;40(3):285-301 - PubMed
  31. Am J Clin Pathol. 2016 Apr;145(4):449-58 - PubMed
  32. J Cancer Res Clin Oncol. 2008 Dec;134(12):1277-87 - PubMed
  33. Int J Gynecol Cancer. 2015 Mar;25(3):453-8 - PubMed
  34. Am J Surg Pathol. 2011 Apr;35(4):522-9 - PubMed
  35. Obstet Gynecol. 1971 Oct;38(4):613-28 - PubMed
  36. Radiat Oncol. 2013 May 24;8:128 - PubMed
  37. Br J Obstet Gynaecol. 1992 Jul;99(7):590-4 - PubMed

Publication Types