Journals / Turkish Journal of Obstetrics and Gynecology / 2015 / Cilt: 12 - Sayı: 3

Yüksek hacimli bir kanser merkezinde uterin leiomyosarkomlu 37 olgunun analizi

An analysis of 37 patients with uterine leiomyosarcoma at a high-volume cancer center

Pages
158–163
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Univariate and multivariate analyses were used to identify the risk factors for overall survival (OS) and progression-free survival (PFS).Results: The majority of patients had stage 1 disease (IA, n=9 (24.3%); IB, n=23 (62.1%)).

📌 3 Key Takeaways

🎯
Objective & Hypothesis:To evaluate the clinicopathologic characteristics, treatment methods, survival, and prognosis of uterine leiomyosarcoma (ULMS).
📊
Key Findings & Data:Materials and Methods: All patients with ULMS who were treated between January 1998 and October 2012 were retrospectively reviewed.
💡
Conclusion & Impact:Univariate and multivariate analyses were used to identify the risk factors for overall survival (OS) and progression-free survival (PFS).Results: The majority of patients had stage 1 disease (IA, n=9 (24.3%); IB, n=23 (62.1%)).
🔬Design:Review & Systematic Survey
📍Scope:2012 Verileri
⚙️Variables:Domain Parameters

Abstract

To evaluate the clinicopathologic characteristics, treatment methods, survival, and prognosis of uterine leiomyosarcoma (ULMS). Materials and Methods: All patients with ULMS who were treated between January 1998 and October 2012 were retrospectively reviewed. A total of 37 women who met the inclusion criteria were included in the present study. Univariate and multivariate analyses were used to identify the risk factors for overall survival (OS) and progression-free survival (PFS).Results: The majority of patients had stage 1 disease (IA, n=9 (24.3%); IB, n=23 (62.1%)). All patients underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. Additionally, only pelvic, and pelvic plus para-aortic lymphadenectomy was performed in 5 (13.5%) and 8 (21.6%) women, respectively. Adjuvant treatment was administered to 27 (72.9%) patients. Patients who did not receive adjuvant therapy had stage 1 disease. Recurrences occurred in 5 (13.5%) patients. The median follow-up period was 71 months (range 1-158 months). The 5-year PFS and OS rates were 68% and 74%, for all patients. The 5-year OS rates for women with stage 1 and >= stage 2 disease were 82% and 27%, respectively. Multivariate analysis confirmed stage 1 disease as the only independent predictor of both PFS (Odds ratio (OR) 10.955, 95% confidence interval (CI) 1.686-71.181, (p=0.012)) and OS (OR 57.429, 95% CI 3.287-1003.269, (p=0.006)).Conclusions: Extensive surgery is not associated with prognosis and stage 1 disease is the only independent good prognostic factor for survival in patients with ULMS

Özet

Uterin leiomyosarkomun (ULMS) klinikopatolojik özelliklerini, tedavi yöntemlerini, sağkalım özelliklerini ve prognozunu değerlendirmek.Gereç ve Yöntem: Ocak 1998 ile Ekim 2012 arasında ULMS tanısıyla tedavi verilen tüm hastalar retrospektif olarak değerlendirildi. Dışlama kriterleri sonrasında toplam 37 kadın çalışmaya dahil edildi. Toplam sağkalım (TS) ve progresyonsuz sağkalım (PS) ile ilişkili risk faktörlerini belirlemek üzere tek değişkenli ve çok değişkenli analizler yapıldı.Bulgular: Hastaların çoğunda evre 1 hastalık mevcuttu (IA, n=9 (%24,3); IB, n=23 (%62,1)). Hastaların hepsine total abdominal histerektomi ve bilateral salpingo-ooforektomi yapıldığı görüldü. Ek olarak, sadece pelvik ve hem pelvik hem paraaortik lenfadenektominin sırasıyla 5 (%13,5) ve 8 (%21,6) hastada uygulanmış olduğu belirlendi. Adjuvan tedavi 27 (%72,9) hastaya uygulanmıştı. Adjuvan tedavi almayan hastalar evre 1 idi. Beş (%13,5) hastada rekürrens saptandı. Ortanca takip periyodu 71 (1-158 ay aralığında) ay olarak bulundu. Tüm hastalar için 5-yıllık PS ve TS oranları sırasıyla %68 ve %74 olarak belirlendi. Evre 1 ve >= evre 2 hastalarda 5-yıllık TS oranları sırasıyla %82 ve %27 idi. Çok değişkenli analizde evre 1 hastalık, PS (Odds oranı (OO) 10,955, %95 güven aralığı (GA) 1,686-71,181, (p=0,012)) ve TS (OO %57,429, 95 GA 3,287-1003,269, (p=0,006)) için tek bağımsız belirleyici olarak bulundu. Sonuç: ULMS'li hastalarda, ekstensif cerrahi, prognozla ilişkili değildir ve evre 1 hastalık sağkalım için tek bağımsız prognostik faktördür

🔖

Cite This Article

SOLMAZ, U., DERELİ, L., DEMİRTAŞ, G. S., EKİN, A., MAT, E., GEZER, C., HASDEMİR, P. S., SAYHAN, S., SANCI, M., AŞKAR, N. (2015). Yüksek hacimli bir kanser merkezinde uterin leiomyosarkomlu 37 olgunun analizi. Turkish Journal of Obstetrics and Gynecology, Cilt: 12 - Sayı: 3, 158–163. https://ajindex.com/articles/376385

References (11)

  1. Zivanovic O, Leitao MM, Iasonos A, Jacks LM, Zhou Q, Abu- Rustum NR, et al. Stage-Specific outcomes of patients with uterine leiomyosarcoma: A comparison of the International Federation of Gynecology and Obstetrics and American Joint Committee on Cancer Staging Systems. J Clin Oncol 2009;27:2066-72.
  2. Ayhan A, Aksan G, Gultekin M, Esin S, Himmetoglu C, Dursun P, et al. Prognostic factors and the role of lymphadenectomy in uterine leiomyosarcomas. Arch Gynecol Obstet 2009;280:79-85.
  3. Goff BA, Rice LW, Fleischhacker D, Muntz HG, Falkenberry SS, Nikrui N, et al. Uterine leiomyosarcoma and endometrial stromal sarcoma: lymph node metastases and sites of recurrence. Gynecol Oncol 1993;50:105-9.
  4. Tasci T, Karalok A, Taskin S, Ureyen I, Kımyon G, Tulek F, et al. Does lymphadenectomy improve survival in uterine leiomyosarcoma? Int J Gynecol Cancer 2015;25:1031-6.
  5. Kapp DS, Shin JY, Chan JK. Prognostic factors and survival in 1,396 patients with uterine leiomyosarcomas: emphasis on impact of lymphadenectomy and oophorectomy. Cancer 2008;112:820-30. D'Angelo E and Prat J. Uterine sarcomas: a review. Gynecol Oncol 2010;116:131-9.
  6. Bell SW, Kempson RL, Hendrickson MR. Problematic uterine smooth muscle neoplasms. A clinicopathologic study of 213 cases. Am J Surg Pathol 1994;18:535-58.
  7. Hsieh CH, Lin H, Huang CC, Huang EY, Chang SY, Chang Chien CC. Leiomyosarcoma of the uterus: a clinicopathologic study of 21 cases. Acta Obstet Gynecol Scand 2003;82:74-81
  8. Major FJ, Blessing JA, Silverberg SG, Morrow CP, Creasman WT, Currie JL, et al. Prognostic factors in early stage uterine sarcoma. Cancer 1993;71:1902-9. Giuntoli RL 2nd, Metzinger DS, DiMarco CS, Cha SS, Sloan JA, Keeney Gl, et al. Retrospective review of 208 patients with leiomyosarcoma of the uterus: prognostic indicators, surgical management, and adjuvant therapy. Gynecol Oncol 2003;89:460-9.
  9. Pautier P, Genestie C, Rey A, Morice P, Roche B, Lhommé C, et al. Analysis of clinicopathologic prognostic factors for 157 uterine sarcomas and evaluation of a grading score validated for soft tissue sarcoma. Cancer 2000;88:1425-31.
  10. Evans HL, Chawla SP, Simpson C, Finn KP. Smooth muscle neoplasm of the uterus other than ordinary leiomyoma: a study of 46 cases, with emphasis on diagnostic criteria and prognostic factor. Cancer 1988;62:2239-47.
  11. Larson B, Silfversward C, Nilsson B, Petterson F. Prognostic factors in uterine leiomyosarcoma: a clinicopathologic study of 143 cases. The Radiumhemmet series, 1936-1981. Acta Oncol 1990;29:185-