Current Status of Uterine Leiomyosarcoma in the Tohoku Region: Results of the Tohoku Translational Center Development Network Survey

Int J Clin Oncol. 2017 Jun;22(3):541-547. doi: 10.1007/s10147-017-1097-y. Epub 2017 Feb 10.

Abstract

Background: To prepare for a future clinical trial for improving the long-term prognosis of patients with uterine leiomyosarcoma (ULMS), we conducted a multi-institutional survey in the Tohoku region of Japan.

Methods: We conducted a retrospective cohort study between 2011 and 2014 in member institutions of the Tohoku Translational Research Center Development Network.

Results: A total of 53 patients with ULMS were registered in 31 institutions for the present survey. The median patient age was 56 years, 67.9% of the patients were postmenopausal, 88.7% had a performance status of 0 or 1, and only 6 patients (11.3%) showed preoperative evidence of malignancy. Although retroperitoneal lymphadenectomy was performed in only 26.4% of patients, 64.2% patients were identified as having FIGO stage 1 disease; 73.6% were eligible to undergo complete surgery. Among 36 patients who were treated with postoperative chemotherapy, 28 (77.8%) received docetaxel and gemcitabine combination therapy. The most frequent recurrence site was the lungs, and the median progression-free survival of all enrolled patients was 11.7 months. However, the median progression-free survival and the median overall survival in patients with stages III and IV disease were 3.4 and 11.4 months, respectively.

Conclusion: Although ULMS was associated with a high rate of complete or optimal surgery, the long-term prognosis was poor. Effective postoperative therapy should be developed to improve the long-term prognosis of patients with ULMS.

Keywords: Retrospective survey; Tohoku region; Uterine leiomyosarcoma.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Combined Modality Therapy
  • Deoxycytidine / administration & dosage
  • Deoxycytidine / analogs & derivatives
  • Disease-Free Survival
  • Docetaxel
  • Female
  • Gemcitabine
  • Health Surveys
  • Humans
  • Japan / epidemiology
  • Leiomyosarcoma / pathology*
  • Lymph Node Excision / statistics & numerical data
  • Middle Aged
  • Neoplasm Recurrence, Local / pathology
  • Prognosis
  • Retrospective Studies
  • Taxoids / administration & dosage
  • Uterine Neoplasms / mortality*
  • Uterine Neoplasms / pathology
  • Uterine Neoplasms / therapy*

Substances

  • Taxoids
  • Deoxycytidine
  • Docetaxel
  • Gemcitabine