Cancer Res Treat.  2009 Mar;41(1):24-28.

Uterine Leiomyosarcoma : 14-year Two-center Experience of 31 Cases

• Kim WY
• Chang SJ
• Chang KH
• Yoon JH
• Kim JH
• Kim BG
• Bae DS
• Ryu HS

Abstract

PURPOSE: The aim of this study was to evaluate the clinicopathological characteristics of uterine leiomyosarcoma (LMS) and possible prognostic factors.
MATERIALS AND METHODS
This study included 31 patients with histologically proven LMS at Samsung Medical Center and Ajou University Hospital between 1994 and 2007. The medical records and available histological slides were reviewed retrospectively.
RESULTS
The median age was 46 years (range, 32~63). The most common symptom was vaginal bleeding (11 patients, 35.5%). There were 23 patients with stage I, one patient with stage III, seven patients with stage IV disease. The median follow up time was 29 months (range, 1~94). The most common recurrence site was lung (5 case), followed by pelvis and upper abdomen (2 case). Nine patients died of disease with a 5-year overall survival rate of 63%. Early tumor stage and mitotic count were the prognostic factor in univariate analysis (p<0.0001 and p=0.0031, respectively), but early tumor stage only was associated with prognosis in multivariate analysis (p=0.010 vs p=0.143). Adjuvant treatment for early stage disease did not decrease the recurrence rate (p=0.1075), but high mitotic count (15>10HPF) had a trend for disease recurrence in early stage LMS (p=0.0859).
CONCLUSION
Mitotic count less than 15/HPF in early stage may be related with longer progression-free interval, but we could not reach the conclusion that adjuvant therapy in early stage LMS be effective.

Keyword

Stage; Mitotic count; Adjuvant therapy; Prognostic factor

MeSH Terms

Abdomen
Follow-Up Studies
Humans
Leiomyosarcoma
Lung
Medical Records
Multivariate Analysis
Pelvis
Prognosis
Recurrence
Retrospective Studies
Survival Rate
Uterine Hemorrhage

Figure

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  Fig. 1 Overall survival of 31 patients.

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  Fig. 2 Survival comparison between patients with early stage and patients with advanced stage (p<0.0001).

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  Fig. 3 Disease free survival in early stage disease (n=23).

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  Fig. 4 Survival comparison between patients with high mitotic count and patients with low mitotic count (p=0.0859).

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