Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 26, 2020; 8(10): 1887-1896
Published online May 26, 2020. doi: 10.12998/wjcc.v8.i10.1887
Outcomes of patients with pelvic leiomyosarcoma treated by surgery and relevant auxiliary diagnosis
Qian Sun, Xin Yang, Zhen Zeng, Xiao Wei, Ke-Zhen Li, Xiao-Yan Xu
Qian Sun, Xin Yang, Zhen Zeng, Xiao Wei, Ke-Zhen Li, Xiao-Yan Xu, Department of Obstetrics and Gynaecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
Author contributions: Sun Q and Yang X designed and performed the research; Wei X and Zeng Z conceptualized the study and analyzed the clinical data; Li KZ and Xu XY supervised the study; Sun Q and Yang X contributed equally to this work; all authors approved the submitted version.
Supported by National Natural Science Foundation of China, No. 81501530; Scientific Research Projects of Hubei Health Commission, No. WJ2019M130; and Scientific Research Fund of Tongji Hospital, No. 2018B02.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology.
Informed consent statement: The analysis used anonymous clinical data obtained from each patient who agreed to the treatment by written consent.
Conflict-of-interest statement: The authors declare no conflict of interest related to this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Xiao-Yan Xu, PhD, Doctor, Department of Obstetrics and Gynaecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan 430030, Hubei Province, China. xuxiaoyan@tjh.tjmu.edu.cn
Received: December 30, 2019
Peer-review started: December 30, 2019
First decision: April 1, 2020
Revised: April 7, 2020
Accepted: April 22, 2020
Article in press: April 22, 2020
Published online: May 26, 2020
Processing time: 146 Days and 20.4 Hours
Abstract
BACKGROUND

Leiomyosarcoma is a subtype of soft tissue sarcoma with adverse outcomes. Leiomyosarcoma accounts for nearly 70% of all uterine sarcomas and is responsible for a considerable proportion of deaths because of uterine cancer. Clinical characteristics and relevant diagnosis of pelvic leiomyosarcoma should be further explored.

AIM

To identify the outcome and relevant perioperative evaluation of patients with pelvic leiomyosarcoma.

METHODS

The Kaplan-Meier method was used to determine progression-free survival and overall survival rates. Factors predictive of outcomes were identified using univariate and multivariate Cox proportional hazards models.

RESULTS

Fifty-one patients with pelvic leiomyosarcoma were enrolled and divided into two groups including uterine leiomyosarcoma and non-uterine leiomyosarcoma. Overall, 28.6% and 45.5% of uterine leiomyosarcoma and non-uterine leiomyosarcoma patients, respectively, had elevated carbohydrate antigen 125 levels, whereas 45.7% and 68.8%, respectively, underwent ultrasonography. Although 68.8% of uterine leiomyosarcoma patients were initially diagnosed with hysteromyoma, 72.7% of non-uterine leiomyosarcoma patients had pelvic and abdominal masses. Moreover, 93.3% of the recurrent lesions were detected using ultrasonography. Patients with International Federation of Gynaecology and Obstetrics (FIGO) stages III–IV disease had poorer progression-free survival values than those with FIGO stages I–II (P = 0.027) disease. FIGO stage was significantly associated with poor progression-free survival in the univariate (hazard ratio = 2.64, P = 0.03) and multivariate (hazard ratio = 2.49, P = 0.048) analyses.

CONCLUSION

Serum tumour biomarkers cannot be used for pelvic leiomyosarcoma diagnosis. FIGO stage is critical to predict the outcome of uterine leiomyosarcoma. Ultrasonography is more reliable for postoperative follow-up than preoperative diagnosis.

Keywords: Uterine leiomyosarcoma; Non-uterine leiomyosarcoma; Serum biomarker; Prognosis; Ultrasonography

Core tip: Owing to a lack of long-term leiomyosarcoma-focused studies, the clinical features of pelvic leiomyosarcoma among women remain unclear. Our study showed that serum tumour biomarkers cannot be used for pelvic leiomyosarcoma diagnosis and ultrasonography is more reliable for postoperative follow-up than preoperative diagnosis.