Prognostic factors and survival in patients treated surgically for primary and recurrent uterine leiomyosarcoma: a single center experience.

AIM

To (i) determine prognostic factors after initial surgery for uterine leiomyosarcomas (LMS) and their recurrence and (ii) assess the effectiveness of re-resections.

PATIENTS AND METHODS

All cases that underwent surgery for uterine leiomyosarcomas at the Fundeni Clinical Institute, Bucharest between 2002 and 2013 were reviewed. Twenty-six patients with primary uterine leiomyosarcomas were introduced in our study. Sixteen of them were re-addressed to the same hospital for recurrence.

RESULTS

At the moment of initial surgery the most important prognostic factors were age <60 years, International Federation of Gynecology and Obstetrics (FIGO) stage I, tumor dimension <15 cm and mitotic index <15/10 high-power fields (HPF). The five-year overall survival was 40%. Sixteen patients were re-operated for recurrence; the most important prognostic factors being a late recurrence (>12 months) and initial FIGO stage I. The five-year overall survival was 12.5%.

CONCLUSION

Uterine leiomyosarcoma is an aggressive malignancy with a high rate of recurrence. In selected cases surgery may be attempted for re-recurrence.