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. 2014 Dec 18:14:981.
doi: 10.1186/1471-2407-14-981.

Distinctive outcome in patients with non-uterine and uterine leiomyosarcoma

Wolfgang Lamm, Camilla Natter, Sophie Schur, Wolfgang J Köstler, Alexander Reinthaller, Michael Krainer, Christoph Grimm, Reinhard Horvath, Gabriele Amann, Philipp Funovics, Thomas Brodowicz, Stephan Polterauer  1
Affiliations

Distinctive outcome in patients with non-uterine and uterine leiomyosarcoma

Wolfgang Lamm et al. BMC Cancer. .

Abstract

Background: Leiomyosarcomas represent the largest subtype of soft tissue sarcomas. Two subgroups can be distinguished, non-uterine (NULMS) and uterine leiomyosarcomas (ULMS). The aim of this retrospective study was to evaluate differences in clinical features and outcome between these two subgroups.

Methods: Outcome and clinical-pathological parameters between 50 patients with NULMS and 45 patients with ULMS were assessed, and compared between both groups. Univariate and multivariable survival analyses were performed.

Results: Patients with ULMS presented with larger tumors when compared to patients with NULMS (p < 0.001). More patients with ULMS initially presented with metastatic disease (67% vs. 36%, p = 0.007). Most common metastatic site was lung for both subtypes (28% and 38%). Five-year overall survival (OS) rates of 82.6% and 41.2% and median OS times of 92.6 (range: 79.7-105.4) and 50.4 (range: 34.8-66.0) months were observed in patients with NULMS and ULMS, respectively (p = 0.006). In multivariate analysis, initial metastatic disease remained an independent prognostic factor in terms of OS (p < 0.0001).

Conclusion: At time of diagnosis ULMS were larger and more often metastasized. Therefore patients with ULMS showed unfavorable outcome when compared to NULMS. Later diagnosis might be caused by differences in symptoms and clinical presentation or a more aggressive biological tumor behavior.

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Figures

Figure 1
Figure 1
Overall survival for patients with NULMS (green curve) vs. ULMS (blue curve) (p = 0.006); 5 yr OSR 82.6% (NULMS) vs. 41.2% (ULMS).
Figure 2
Figure 2
Overall survival for patients with localized (blue line) vs. initially metastasized (green line) NULMS and ULMS (p < 0.001); 5 yr OSR 91.3% vs. 29.6%.
Figure 3
Figure 3
Subgroup analysis: overall survival between initially metastatic NULMS (green curve) and ULMS (blue curve) (5-yr OS: NULMS: 44.4%; ULMS: 16.9%; p = 0.22).
Figure 4
Figure 4
Impact of gender on overall survival of patients with NULMS (p = 0.96); 5 yr OSR 76.6% (male) (blue curve) vs. 77.9% (female) (pink curve).
Figure 5
Figure 5
Subgroup analysis: overall survival between initially localized NULMS (green curve) and ULMS (blue curve) (5-yr OS: NULMS: 96.0%; ULMS: 81.3%; p = 0.27).
Figure 6
Figure 6
Subgroup analysis: overall survival between initially metastatic NULMS (green curve) and ULMS (blue curve) (5-yr OS: NULMS: 44.4%; ULMS: 16.9%; p = 0.22).
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Pre-publication history
    1. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2407/14/981/prepub

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