Histopathologic prognostic factors in stage i leiomyosarcoma of the uterus: A detailed analysis of 27 cases

American Journal of Surgical Pathology

Volumn 35, Issue 4, 2011, Pages 522-529

  Wang, Wei Lien ^a   Soslow, Robert ^b   Hensley, Martee ^b   Asad, Haider ^b   Zannoni, Gian Franco ^c   De Nictolis, Michele ^d   Branton, Philip ^e   Muzikansky, Alona ^a   Oliva, Esther ^a  

^a MASSACHUSETTS GENERAL HOSPITAL   (United States)

^b MEMORIAL SLOAN KETTERING CANCER CENTER   (United States)

^c CATHOLIC UNIVERSITY   (Italy)

^d Istituto di Istologia   (Italy)

^e INOVA FAIRFAX HOSPITAL   (United States)

Author keywords

age; cytologic atypia; histologic subtypes; leiomyosarcoma; mitotic rate; prognosis; stage I; tumor cell necrosis; tumor size; Uterus

Indexed keywords

ADULT; AGED; ARTICLE; CANCER STAGING; CASE REPORT; FEMALE; HUMAN; LEIOMYOSARCOMA; MIDDLE AGED; MORTALITY; PATHOLOGY; PROGNOSIS; SURVIVAL RATE; UNITED STATES; UTERUS; UTERUS CANCER;

ADULT; AGED; FEMALE; HUMANS; LEIOMYOSARCOMA; MIDDLE AGED; NEOPLASM STAGING; PROGNOSIS; SURVIVAL RATE; UNITED STATES; UTERINE NEOPLASMS; UTERUS;

EID: 79953232739     PISSN: 01475185     EISSN: 15320979     Source Type: Journal    
DOI: 10.1097/PAS.0b013e31820ca624     Document Type: Article

References (71)

1. Aaro LA, Symmonds RE, Dockerty MB. Sarcoma of the uterus: a clinical and pathologic study of 177 cases. Am J Obstet Gynecol. 1966;94:101-109.
2. Abeler VM, Royne O, Thoresen S, et al. Uterine sarcomas in Norway: a histopathological and prognostic survey of a total population from 1970 to 2000 including 419 patients. Histopathology. 2009;54:355-364.
3. Akhan SE, Yavuz E, Tecer A, et al. The expression of Ki-67, p53, estrogen and progesterone receptors affecting survival in uterine leiomyosarcomas: a clinicopathologic study. Gynecol Oncol. 2005;99:36-42. (Pubitemid 41354580)
4. Anderson SE, Nonaka D, Chuai S, et al. p53, epidermal growth factor, and platelet-derived growth factor in uterine leiomyosarcoma and leiomyomas. Int J Gynecol Cancer. 2006;16:849-853.
5. Atkins K, Bell SW, Kempson RL. Myxoid smooth muscle tumors of the uterus. Mod Pathol. 2001;14:132A.
6. Atkins K, Bell SW, Kempson RL, et al. Epitlelioid smooth muscle tumors of the uterus. Mod Pathol. 2001;14.
7. Barter JF, Smith EB, Szpak CA, et al. Leiomyosarcoma of the uterus: clinicopathologic study of 21 cases. Gynecol Oncol. 1985;21:220-227. (Pubitemid 15052597)
8. Bell SW, Kempson RL, Hendrickson MR. Problematic uterine smooth muscle neoplasms: a clinicopathologic study of213 cases. Am J Surg Pathol. 1994;18:535-558. (Pubitemid 24150803)
9. Benedet JL, Bender H, Jones H III, et al. FIGO staging classifications and clinical practice guidelines in the management of gynecologic cancers. FIGO Committee on Gynecologic Oncol-ogy. Int J Gynaecol Obstet. 2000;70:209-262.
10. Bodner-Adler B, Bodner K, Kimberger O, et al. MMP-1 and MMP-2 expression in uterine leiomyosarcoma and correlation with different clinicopathologic parameters. J Soc Gynecol Investig. 2003;10:443-446. (Pubitemid 37159232)
11. Bodner K, Bodner-Adler B, Kimberger O, et al. Evaluating prognostic parameters in women with uterine leiomyosarcoma: a clinicopathologic study. J Reprod Med. 2003;48:95-100. (Pubitemid 36249753)
12. Brooks SE, Zhan M, Cote T, et al. Surveillance, epidemiology, and end results analysis of 2677 cases of uterine sarcoma 1989-1999. Gynecol Oncol. 2004;93:204-208. (Pubitemid 38429571)
13. Christopherson WM, Williamson EO, Gray LA. Leiomyosarcoma of theuterus. Cancer. 1972;29:1512-1517.
14. Coard KC, Fletcher HM. Leiomyosarcoma of the uterus with a florid intravascular component ("intravenous leiomyosarcomatosis"). Int J Gynecol Pathol. 2002;21:182-185. (Pubitemid 34260640)
15. D'Angelo E, Spagnoli LG, Prat J. Comparative clinicopathologic and immunohistochemical analysis of uterine sarcomas diagnosed using the World Health Organization classification system. Hum Pathol. 2009;40:1571-1585.
16. Denschlag D, Masoud I, Stanimir G, et al. Prognostic factors and outcome in women with uterine sarcoma. Eur J Surg Oncol. 2007;33:91-95. (Pubitemid 46156623)
17. Dinh TA, Oliva EA, Fuller AF Jr, et al. The treatment of uterine leiomyosarcoma: results from a 10-year experience (1990-1999) at the Massachusetts General Hospital. Gynecol Oncol. 2004;92: 648-652. (Pubitemid 38183158)
18. Downes KA, Hart WR. Bizarre leiomyomas of the uterus: a comprehensive pathologic study of 24 cases with long-term follow-up. Am J Surg Pathol. 1997;21:1261-1270. (Pubitemid 27460853)
19. Evans HL, Chawla SP, Simpson C, et al. Smooth muscle neoplasms of the uterus other than ordinary leiomyoma: a study of 46 cases, with emphasis on diagnostic criteria and prognostic factors. Cancer. 1988;622239-2247.
20. Friedrich M, Villena-Heinsen C, Mink D, et al. Leiomyosarcomas of the female genital tract: a clinical and histopathological study. Eur J Gynaecol Oncol. 1998;19:470-475. (Pubitemid 28479399)
21. Gadducci A, Fabrini MG, Bonuccelli A, et al. Analysis of treatment failures in patients with early-stage uterine leiomyosarcoma. Anti-cancer Res. 1995;15:485-488.
22. Gadducci A, Landoni F, Sartori E, et al. Uterine leiomyosarcoma: analysis of treatment failures and survival. Gynecol Oncol. 1996; 6225-32.
23. Gadducci A, Sartori E, Landoni F, et al. The prognostic relevance of histological type in uterine sarcomas: a Cooperation Task Force (CTF) multivariate analysis of 249 cases. Eur J Gynaecol Oncol. 2002;23:295-299. (Pubitemid 34948043)
24. Gadducci A, Cosio S, Romanini A, et al. The management of patients with uterine sarcoma: a debated clinical challenge. Crit Rev Oncol Hematol. 2008;65:129-142.
25. Giuntoli RL II, Bristow RE. Uterine leiomyosarcoma: present management. Curr Opin Oncol. 2004;16:324-327. (Pubitemid 38870037)
26. Giuntoli RL II, Metzinger DS, DiMarco CS, et al. Retrospective review of 208 patients with leiomyosarcoma of the uterus: prognostic indicators, surgical management, and adjuvant therapy. Gynecol Oncol. 2003;89:460-469. (Pubitemid 36687793)
27. Greene FL. American Joint Committee on Cancer, American Cancer Society, AJCC Cancer Staging Manual. New York: Springer-Verlag; 2002.
28. Hannigan EV, Gomez LG. Uterine leiomyosarcoma. Am J Obstet Gynecol. 1979;134:557-564.
29. Harlow BL, Weiss NS, Lofton S. The epidemiology of sarcomas of the uterus. J Natl Cancer Inst. 1986;76:399-402. (Pubitemid 16119773)
30. Hsieh CH, Lin H, Huang CC, et al. Leiomyosarcoma of the uterus: a clinicopathologic study of 21 cases. Acta Obstet Gynecol Scand. 2003;82:74-81. (Pubitemid 36228411)
31. Jeffers MD, Farquharson MA, Richmond JA, et al. p53 immunor-eactivity and mutation of the p53 gene in smooth muscle tumours of the uterine corpus. J Pathol. 1995;177:65-70.
32. Jones MW, Norris HJ. Clinicopathologic study of 28 uterine leiomyosarcomas with metastasis. Int J Gynecol Pathol. 1995;14: 243-249.
33. Kabbani W, Deavers MT, Malpica A, et al. Uterine tumor resembling ovarian sex-cord tumor: report of a case mimicking cervical adenocarcinoma. Int J Gynecol Pathol. 2003;22:297-302. (Pubitemid 36750415)
34. Kahanpaa KV, Wahlstrom T, Grohn P, et al. Sarcomas of the uterus: a clinicopathologic study of 119 patients. Obstet Gynecol. 1986;67:417-424. (Pubitemid 16129989)
35. Kapp DS, Shin JY, Chan JK. Prognostic factors and survival in 1396 patients with uterine leiomyosarcomas: emphasis on impact of lymphadenectomy and oophorectomy. Cancer. 2008;112: 820-830. (Pubitemid 351240576)
36. Kempson RL, Hendrickson MR. Smooth muscle, endometrial stromal, and mixed Mullerian tumors of the uterus. Mod Pathol. 2000;13:328-342. (Pubitemid 30207516)
37. Kindelberger D, Hollowell M, Otis C, et al. Myxoid Leiomyosarco-ma: a clinicopathologic study of ten cases. Mod Pathol. 2007;20: 203A-204A.
38. King ME, Dickersin GR, Scully RE. Myxoid leiomyosarcoma of the uterus: a report of six cases. Am J Surg Pathol. 1982;6:589-598. (Pubitemid 13234756)
39. Kokawa K, Nishiyama K, Ikeuchi M, et al. Clinical outcomes of uterine sarcomas: results from 14 years worth of experience in the Kinki district in Japan (1990-2003). Int J Gynecol Cancer. 2006; 16:1358-1363. (Pubitemid 43886769)
40. Kurman RJ, Norris HJ. Mesenchymal tumors of the uterus. VI. Epithelioid smooth muscle tumors including leiomyoblastoma and clear-cell leiomyoma: a clinical and pathologic analysis of 26 cases. Cancer. 1976;37:1853-1865.
41. Kushner DM, Webster KD, Belinson JL, et al. Safety and efficacy of adjuvant single-agent ifosfamide in uterine sarcoma. Gynecol Oncol. 2000;78:221-227. (Pubitemid 30650358)
42. Larson B, Silfversward C, Nilsson B, et al. Prognostic factors in uterine leiomyosarcoma. A clinical and histopathological study of 143 cases. The Radiumhemmet series 1936-1981. Acta Oncol. 1990;29:185-191. (Pubitemid 20145283)
43. Leitao MM, Soslow RA, Nonaka D, et al. Tissue microarray immunohistochemical expression of estrogen, progesterone, and androgen receptors in uterine leiomyomata and leiomyosarcoma. Cancer. 2004;101:1455-1462. (Pubitemid 39180402)
44. Major FJ, Blessing JA, Silverberg SG, et al. Prognostic factors in early-stage uterine sarcoma: a Gynecologic Oncology Group study. Cancer. 1993;71:1702-1709. (Pubitemid 23056094)
45. Mayerhofer K, Obermair A, Windbichler G, et al. Leiomyosarcoma of the uterus: a clinicopathologic multicenter study of 71 cases. Gynecol Oncol. 1999;74:196-201. (Pubitemid 29377212)
46. Mayerhofer K, Lozanov P, Bodner K, et al. Ki-67 expression in patients with uterine leiomyomas, uterine smooth muscle tumors of uncertain malignant potential (STUMP) and uterine leiomyosarco-mas (LMS). Acta Obstet Gynecol Scand. 2004;83:1085-1088. (Pubitemid 39457489)
47. Mittal K, Demopoulos RI. MIB-1 (Ki-67), p53, estrogen receptor, and progesterone receptor expression in uterine smooth muscle tumors. Hum Pathol. 2001;32:984-987. (Pubitemid 32911322)
48. Nordal RN, Kjorstad KE, Stenwig AE, et al. Leiomyosarcoma (LMS) and endometrial stromal sarcoma (ESS) of the uterus: a survey of patients treated in the Norwegian Radium Hospital 1976-1985. Int J Gynecol Cancer. 1993;3:110-115. (Pubitemid 23209545)
49. Nordal RR, Kristensen GB, Kaern J, et al. The prognostic significance of stage, tumor size, cellular atypia and DNA ploidy in uterine leiomyosarcoma. Acta Oncol. 1995;34:797-802.
50. Nordal RR, Thoresen SO. Uterine sarcomas in Norway 1956-1992: incidence, survival and mortality. Eur J Cancer. 1997;33:907-911. (Pubitemid 27287045)
51. O'Neill CJ, McBride HA, Connolly LE, et al. Uterine leiomyosar-comas are characterized by high p16, p53 and MIB1 expression in comparison with usual leiomyomas, leiomyoma variants and smooth muscle tumours of uncertain malignant potential. Histo-pathology. 2007;50:851-858. (Pubitemid 46850073)
52. Olah KS, Dunn JA, Gee H. Leiomyosarcomas have a poorer prognosis than mixed mesodermal tumours when adjusting for known prognostic factors: the result of a retrospective study of 423 cases of uterine sarcoma. Br J Obstet Gynaecol. 1992;99:590-594.
53. Oliva E, Nielsen GP, Clement PB, et al. Epithelioid smooth muscle tumors of the uterus: a clinicopathologic analysis of 80 cases. Mod Pathol. 1997;10:107A.
54. Omura GA, Blessing JA, Major F, et al. A randomized clinical trial of adjuvant adriamycin in uterine sarcomas: a Gynecologic Oncology Group Study. J Clin Oncol. 1985;3:1240-1245. (Pubitemid 15226529)
55. Pautier P, Genestie C, Rey A, et al. Analysis of clinicopathologic prognostic factors for 157 uterine sarcomas and evaluation of a grading score validated for soft tissue sarcoma. Cancer. 2000;88:1425-1431. (Pubitemid 30155181)
56. Peacock G, Archer S. Myxoid leiomyosarcoma of the uterus: case report and review of the literature. Am J Obstet Gynecol. 1989;160:1515-1518; discussion 1518-1519.
57. Piver MS, Rose PG. Advanced uterine sarcoma; response to chemotherapy. Eur J Gynaecol Oncol. 1988;9:124-129.
58. Piver MS, Lele SB, Marchetti DL, et al. Effect of adjuvant chemotherapy on time to recurrence and survival of stage I uterine sarcomas. J Surg Oncol. 1988;38:233-239.
59. Prayson RA, Goldblum JR, Hart WR. Epithelioid smooth-muscle tumors of the uterus: a clinicopathologic study of 18 patients. Am J Surg Pathol. 1997;21:383-391. (Pubitemid 27184770)
60. Schwartz LB, Diamond MP, Schwartz PE. Leiomyosarcomas: clinical presentation. Am J Obstet Gynecol. 1993;168:180-183. (Pubitemid 23047637)
61. Schwartz Z, Dgani R, Lancet M, et al. Uterine sarcoma in Israel: a study of 104 cases. Gynecol Oncol. 1985;20:354-363. (Pubitemid 15143761)
62. Silverberg SG. Leiomyosarcoma of the uterus: a clinicopathologic study. Obstet Gynecol. 1971;38:613-628.
63. Skubitz KM, Skubitz AP. Differential gene expression in leiomyo-sarcoma. Cancer. 2003;98:1029-1038.
64. Toledo G, Oliva E. Smooth muscle tumors of the uterus: a practical approach. Arch Pathol Lab Med. 2008;132:595-605. (Pubitemid 351489613)
65. Toro JR, Travis LB, Wu HJ, et al. Incidence patterns of soft tissue sarcomas, regardless of primary site, in the surveillance, epidemio-logy and end results program, 1978-2001: an analysis of 26,758 cases. Int J Cancer. 2006;119:2922-2930. (Pubitemid 44846246)
66. Van Dinh T, Woodruff JD. Leiomyosarcoma of the uterus. Am J Obstet Gynecol. 1982;144:817-823. (Pubitemid 13196596)
67. Vardi JR, Tovell HM. Leiomyosarcoma of the uterus: clinicopatho-logic study. Obstet Gynecol. 1980;56:428-434.
68. Veras E, Malpica A, Deavers MT, et al. Mitosis-specific marker phospho-histone H3 in the assessment of mitotic index in uterine smooth muscle tumors: a pilot study. Int J Gynecol Pathol. 2009;28:316-321.
69. Wang W, Soslow RA, Zannoni G, et al. The utility of tumor cell necrosis in the diagnosis of primary leiomyosarcoma of the uterus: an analysis of 77 cases. Mod Pathol. 2006;18:201A.
70. Wu TI, Chang TC, Hsueh S, et al. Prognostic factors and impact of adjuvant chemotherapy for uterine leiomyosarcoma. Gynecol Oncol. 2006;100:166-172. (Pubitemid 41815068)
71. Zaloudek C, Hendrickson MR. Mesenchymal tumors of the uterus. In: Kurman RJ, ed. Blaustein's Pathology of the Female Genital Tract. New York: Springer-Verlag, Inc.; 2004.