Outcome and prognostic factors in 110 consecutive patients with primary uterine leiomyosarcoma: A rare cancer network study

Alessandra Franzetti Pellanda; Berardino De Bari; Elisabeth Deniaud-Alexandre; Marco Krengli; Paul Van Houtte; Antonella Richetti; Salvador Villà; Hadassah Goldberg; Ewa Szutowicz-Zielińska; Michel Bolla; Heidi Rutten; Marc Van Eijkeren; Philip Poortmans; Guido Henke; Yavuz Anacak; Steve Chan; Christine Landmann; Carine Kirkove; Luciano Scandolaro; Jacques Bernier; René Olivier Mirimanoff; Mahmut Ozsahin

doi:10.21147/j.issn.1000-9604.2017.06.06

Outcome and prognostic factors in 110 consecutive patients with primary uterine leiomyosarcoma: A rare cancer network study

Alessandra Franzetti Pellanda, Berardino De Bari, Elisabeth Deniaud-Alexandre, Marco Krengli, Paul Van Houtte, Antonella Richetti, Salvador Villà, Hadassah Goldberg, Ewa Szutowicz-Zielińska, Michel Bolla, Heidi Rutten, Marc Van Eijkeren, Philip Poortmans, Guido Henke, Yavuz Anacak, Steve Chan, Christine Landmann, Carine Kirkove, Luciano Scandolaro, Jacques BernierRené Olivier Mirimanoff, Mahmut Ozsahin

Research output: Contribution to journal › Article › peer-review

8 Scopus citations

Abstract

Objective: Primary uterine leiomyosarcomas (ULMS) are rare, and the optimal treatment is controversial. We aimed to assess the outcome and prognostic factors in a multicenter population of women treated for primary ULMS. Methods: We retrospectively collected data of 110 women treated in 19 institutions of the Rare Cancer Network (RCN). Inclusion criteria consisted of a pathology report confirming the diagnosis of ULMS, aged 18-80 years, complete International Federation of Gynecology and Obstetrics (FIGO) stage information, complete information on treatment, and a minimum follow-up of 6 months. Local control (LC) and locoregional control (LRC), overall survival (OS) and disease-free survival (DFS) rates were computed using the Kaplan-Meier method. Univariate analysis was implemented using the log rank test, and multivariate analysis using the Cox model. Results: All patients underwent surgery. Seventy-five patients (68%) received adjuvant radiotherapy (RT), including brachytherapy in 18 (16%). Seventeen patients (15%) received adjuvant chemotherapy. Median follow-up was 58 (range, 6-240) months. Five-year OS and DFS rates were 50% and 34%, and LC and LRC rates were 88% and 72%, respectively. On multivariate analysis, independent favorable prognostic factors were younger age, FIGO stage I, small tumor size, previous uterine disease, and no vascular invasion for OS and DFS. FIGO stage was the only favorable factor influencing LRC. Adjuvant local or systemic treatments did not improve the outcomes. Eight patients treated with RT presented a grade 3 acute toxicity, and only one patient with grade 3 late toxicity. Conclusions: In this large population of primary ULMS patients, we found good results in terms of LC and LRC. Nevertheless, OS remains poor, mainly due to the occurrence of distant metastases. An early diagnosis seemed to improve the prognosis of the patients. Adjuvant local or systemic treatments, or more aggressive surgical procedures such as the Wertheim procedure, did not seem to impact the outcome.

Original language	English
Pages (from-to)	521-532
Number of pages	12
Journal	Chinese Journal of Cancer Research
Volume	29
Issue number	6
DOIs	https://doi.org/10.21147/j.issn.1000-9604.2017.06.06
State	Published - Dec 2017
Externally published	Yes

Bibliographical note

Publisher Copyright:
© Chinese Journal of Cancer Research. All rights reserved.

Funding

1Centre Hospitalier Universitaire Vaudois (CHUV), 1011 Lausanne, Switzerland; 2Clinica Luganese Moncucco, 6903 Lugano, Switzerland; 3Centre Hospitalier Régional Universitaire “Jean Minjoz”, INSERM, UMR1098, 25030 Besançon, France; 4Hôpital Tenon, 75970 Paris, France; 5Centre Hospitalier Départemental, 85925 Vendee, France; 6Università degli Studi del Piemonte Orientale e Ospedale Maggiore della Carità, 28100 Novara, Italy; 7Institut Jules Bordet, 1000 Brussels, Belgium; 8Ospedale di Circolo, 21100 Varese, Italy; 9Istituto Oncologico della Svizzera Italiana, EOC, 6500 Bellinzona, Switzerland; 10Catalan Institute of Oncology, Universitat Autònoma de Barcelona, 08916 Barcelona 08916, Spain; 11Rambam Medical Center, 31096 Haifa, Israel; 12Medical University, 80210 Gdansk, Poland; 13Hôpital Michallon, BP217, 38043, Grenoble cedex 09, France; 14Radboud University Medical Center, 6525 Nijmegen, The Netherlands; 15Ghent University Hospital, 9000 Gent, Belgium; 16Institute Verbeeten, 90120 Tilburg, The Netherlands; 17Kantonsspital St. Gallen, 9007, St. Gallen, Switzerland; 18Karadeniz Technical University, 61080 Trabzon, Turkey; 19Nottingham University Hospital, NHS trust, NG5 1PB Nottingham, United Kingdom; 20Kantonsspital Basel, 4031 Basel, Switzerland; 21UCL St. Luc, 1200 Brussels, Belgium; 22Presidio Ospedaliero Sant’Anna, 22100 Como, Italy; 23Ospedale San Giovanni, 6500 Bellinzona, Switzerland; 24Clinique de Genolier, Genolier, 1272 Switzerland *These authors equally contributed as a first author. **These authors equally contributed as a senior author. †Deceased. Correspondence to: Prof. Mahmut Ozsahin, MD, PhD. Department of Radiation Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne, Switzerland. Email: [email protected].

Funders	Funder number
3Centre
Institut national de la santé et de la recherche médicale	UMR1098
Università degli Studi del Piemonte Orientale	38043, BP217, NG5
Centre Hospitalier Universitaire Vaudois

Keywords

Local control
Overall survival
Prognostic factors
Radiotherapy
Uterine leiomyosarcoma

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.21147/j.issn.1000-9604.2017.06.06

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Pellanda, A. F., De Bari, B., Deniaud-Alexandre, E., Krengli, M., Van Houtte, P., Richetti, A., Villà, S., Goldberg, H., Szutowicz-Zielińska, E., Bolla, M., Rutten, H., Van Eijkeren, M., Poortmans, P., Henke, G., Anacak, Y., Chan, S., Landmann, C., Kirkove, C., Scandolaro, L., ... Ozsahin, M. (2017). Outcome and prognostic factors in 110 consecutive patients with primary uterine leiomyosarcoma: A rare cancer network study. Chinese Journal of Cancer Research, 29(6), 521-532. https://doi.org/10.21147/j.issn.1000-9604.2017.06.06

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title = "Outcome and prognostic factors in 110 consecutive patients with primary uterine leiomyosarcoma: A rare cancer network study",

abstract = "Objective: Primary uterine leiomyosarcomas (ULMS) are rare, and the optimal treatment is controversial. We aimed to assess the outcome and prognostic factors in a multicenter population of women treated for primary ULMS. Methods: We retrospectively collected data of 110 women treated in 19 institutions of the Rare Cancer Network (RCN). Inclusion criteria consisted of a pathology report confirming the diagnosis of ULMS, aged 18-80 years, complete International Federation of Gynecology and Obstetrics (FIGO) stage information, complete information on treatment, and a minimum follow-up of 6 months. Local control (LC) and locoregional control (LRC), overall survival (OS) and disease-free survival (DFS) rates were computed using the Kaplan-Meier method. Univariate analysis was implemented using the log rank test, and multivariate analysis using the Cox model. Results: All patients underwent surgery. Seventy-five patients (68\%) received adjuvant radiotherapy (RT), including brachytherapy in 18 (16\%). Seventeen patients (15\%) received adjuvant chemotherapy. Median follow-up was 58 (range, 6-240) months. Five-year OS and DFS rates were 50\% and 34\%, and LC and LRC rates were 88\% and 72\%, respectively. On multivariate analysis, independent favorable prognostic factors were younger age, FIGO stage I, small tumor size, previous uterine disease, and no vascular invasion for OS and DFS. FIGO stage was the only favorable factor influencing LRC. Adjuvant local or systemic treatments did not improve the outcomes. Eight patients treated with RT presented a grade 3 acute toxicity, and only one patient with grade 3 late toxicity. Conclusions: In this large population of primary ULMS patients, we found good results in terms of LC and LRC. Nevertheless, OS remains poor, mainly due to the occurrence of distant metastases. An early diagnosis seemed to improve the prognosis of the patients. Adjuvant local or systemic treatments, or more aggressive surgical procedures such as the Wertheim procedure, did not seem to impact the outcome.",

keywords = "Local control, Overall survival, Prognostic factors, Radiotherapy, Uterine leiomyosarcoma",

author = "Pellanda, \{Alessandra Franzetti\} and \{De Bari\}, Berardino and Elisabeth Deniaud-Alexandre and Marco Krengli and \{Van Houtte\}, Paul and Antonella Richetti and Salvador Vill{\`a} and Hadassah Goldberg and Ewa Szutowicz-Zieli{\'n}ska and Michel Bolla and Heidi Rutten and \{Van Eijkeren\}, Marc and Philip Poortmans and Guido Henke and Yavuz Anacak and Steve Chan and Christine Landmann and Carine Kirkove and Luciano Scandolaro and Jacques Bernier and Mirimanoff, \{Ren{\'e} Olivier\} and Mahmut Ozsahin",

year = "2017",

month = dec,

doi = "10.21147/j.issn.1000-9604.2017.06.06",

language = "אנגלית",

volume = "29",

pages = "521--532",

journal = "Chinese Journal of Cancer Research",

issn = "1000-9604",

publisher = "Chinese Journal of Cancer Research Co., Ltd. and Peking University Cancer Hospital and Institute",

number = "6",

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Pellanda, AF, De Bari, B, Deniaud-Alexandre, E, Krengli, M, Van Houtte, P, Richetti, A, Villà, S, Goldberg, H, Szutowicz-Zielińska, E, Bolla, M, Rutten, H, Van Eijkeren, M, Poortmans, P, Henke, G, Anacak, Y, Chan, S, Landmann, C, Kirkove, C, Scandolaro, L, Bernier, J, Mirimanoff, RO & Ozsahin, M 2017, 'Outcome and prognostic factors in 110 consecutive patients with primary uterine leiomyosarcoma: A rare cancer network study', Chinese Journal of Cancer Research, vol. 29, no. 6, pp. 521-532. https://doi.org/10.21147/j.issn.1000-9604.2017.06.06

TY - JOUR

T1 - Outcome and prognostic factors in 110 consecutive patients with primary uterine leiomyosarcoma

T2 - A rare cancer network study

AU - Pellanda, Alessandra Franzetti

AU - De Bari, Berardino

AU - Deniaud-Alexandre, Elisabeth

AU - Krengli, Marco

AU - Van Houtte, Paul

AU - Richetti, Antonella

AU - Villà, Salvador

AU - Goldberg, Hadassah

AU - Szutowicz-Zielińska, Ewa

AU - Bolla, Michel

AU - Rutten, Heidi

AU - Van Eijkeren, Marc

AU - Poortmans, Philip

AU - Henke, Guido

AU - Anacak, Yavuz

AU - Chan, Steve

AU - Landmann, Christine

AU - Kirkove, Carine

AU - Scandolaro, Luciano

AU - Bernier, Jacques

AU - Mirimanoff, René Olivier

AU - Ozsahin, Mahmut

PY - 2017/12

Y1 - 2017/12

N2 - Objective: Primary uterine leiomyosarcomas (ULMS) are rare, and the optimal treatment is controversial. We aimed to assess the outcome and prognostic factors in a multicenter population of women treated for primary ULMS. Methods: We retrospectively collected data of 110 women treated in 19 institutions of the Rare Cancer Network (RCN). Inclusion criteria consisted of a pathology report confirming the diagnosis of ULMS, aged 18-80 years, complete International Federation of Gynecology and Obstetrics (FIGO) stage information, complete information on treatment, and a minimum follow-up of 6 months. Local control (LC) and locoregional control (LRC), overall survival (OS) and disease-free survival (DFS) rates were computed using the Kaplan-Meier method. Univariate analysis was implemented using the log rank test, and multivariate analysis using the Cox model. Results: All patients underwent surgery. Seventy-five patients (68%) received adjuvant radiotherapy (RT), including brachytherapy in 18 (16%). Seventeen patients (15%) received adjuvant chemotherapy. Median follow-up was 58 (range, 6-240) months. Five-year OS and DFS rates were 50% and 34%, and LC and LRC rates were 88% and 72%, respectively. On multivariate analysis, independent favorable prognostic factors were younger age, FIGO stage I, small tumor size, previous uterine disease, and no vascular invasion for OS and DFS. FIGO stage was the only favorable factor influencing LRC. Adjuvant local or systemic treatments did not improve the outcomes. Eight patients treated with RT presented a grade 3 acute toxicity, and only one patient with grade 3 late toxicity. Conclusions: In this large population of primary ULMS patients, we found good results in terms of LC and LRC. Nevertheless, OS remains poor, mainly due to the occurrence of distant metastases. An early diagnosis seemed to improve the prognosis of the patients. Adjuvant local or systemic treatments, or more aggressive surgical procedures such as the Wertheim procedure, did not seem to impact the outcome.

AB - Objective: Primary uterine leiomyosarcomas (ULMS) are rare, and the optimal treatment is controversial. We aimed to assess the outcome and prognostic factors in a multicenter population of women treated for primary ULMS. Methods: We retrospectively collected data of 110 women treated in 19 institutions of the Rare Cancer Network (RCN). Inclusion criteria consisted of a pathology report confirming the diagnosis of ULMS, aged 18-80 years, complete International Federation of Gynecology and Obstetrics (FIGO) stage information, complete information on treatment, and a minimum follow-up of 6 months. Local control (LC) and locoregional control (LRC), overall survival (OS) and disease-free survival (DFS) rates were computed using the Kaplan-Meier method. Univariate analysis was implemented using the log rank test, and multivariate analysis using the Cox model. Results: All patients underwent surgery. Seventy-five patients (68%) received adjuvant radiotherapy (RT), including brachytherapy in 18 (16%). Seventeen patients (15%) received adjuvant chemotherapy. Median follow-up was 58 (range, 6-240) months. Five-year OS and DFS rates were 50% and 34%, and LC and LRC rates were 88% and 72%, respectively. On multivariate analysis, independent favorable prognostic factors were younger age, FIGO stage I, small tumor size, previous uterine disease, and no vascular invasion for OS and DFS. FIGO stage was the only favorable factor influencing LRC. Adjuvant local or systemic treatments did not improve the outcomes. Eight patients treated with RT presented a grade 3 acute toxicity, and only one patient with grade 3 late toxicity. Conclusions: In this large population of primary ULMS patients, we found good results in terms of LC and LRC. Nevertheless, OS remains poor, mainly due to the occurrence of distant metastases. An early diagnosis seemed to improve the prognosis of the patients. Adjuvant local or systemic treatments, or more aggressive surgical procedures such as the Wertheim procedure, did not seem to impact the outcome.

KW - Local control

KW - Overall survival

KW - Prognostic factors

KW - Radiotherapy

KW - Uterine leiomyosarcoma

UR - https://www.scopus.com/pages/publications/85041120547

U2 - 10.21147/j.issn.1000-9604.2017.06.06

DO - 10.21147/j.issn.1000-9604.2017.06.06

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C2 - 29353974

AN - SCOPUS:85041120547

SN - 1000-9604

VL - 29

SP - 521

EP - 532

JO - Chinese Journal of Cancer Research

JF - Chinese Journal of Cancer Research

IS - 6

ER -

Outcome and prognostic factors in 110 consecutive patients with primary uterine leiomyosarcoma: A rare cancer network study

Abstract

Bibliographical note

Funding

Keywords

UN SDGs

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