Treatment outcome of superficial leiomyosarcoma

Background Nonuterine leiomyosarcomas (LMS) are common extremity soft‐tissue sarcomas. Deep LMS are at an increased risk for recurrence; however, few studies have focused on superficial LMS. Methods We reviewed the clinicopathological features of 82 patients with a primary superficial LMS. The mean...

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Published in:Journal of surgical oncology 2021-01, Vol.123 (1), p.127-132
Main Authors: Wellings, Elizabeth P., Tibbo, Meagan E., Rose, Peter S., Folpe, Andrew L., Houdek, Matthew T.
Format: Article
Language:English
Subjects:
dermal
Female
Follow-Up Studies
Humans
Incidence
leiomyosarcoma
Leiomyosarcoma - pathology
Leiomyosarcoma - surgery
Male
Margins of Excision
Medical prognosis
Middle Aged
Minnesota - epidemiology
Neoplasm Recurrence, Local - pathology
Neoplasm Recurrence, Local - surgery
outcome
Postoperative Complications - epidemiology
Postoperative Complications - mortality
Postoperative Complications - pathology
Prognosis
Retrospective Studies
subcutaneous
superficial
Survival Rate
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Summary:Background Nonuterine leiomyosarcomas (LMS) are common extremity soft‐tissue sarcomas. Deep LMS are at an increased risk for recurrence; however, few studies have focused on superficial LMS. Methods We reviewed the clinicopathological features of 82 patients with a primary superficial LMS. The mean age and follow‐up were 57 ± 15 and 7 ± 5 years. Depth was classified as dermal (based in the skin; n = 35, 43%) and subcutaneous (based below the dermis, above the fascia; n = 47, 57%) on the final resection specimen. Dermal cases were treated with negative margin resection, while subcutaneous tumors were evaluated by a multidisciplinary team for consideration of possible adjuvant therapy. Results The 10‐year disease‐specific survival (DSS) for superficial LMS was 90% with no difference (p = .18) in the 10‐year DSS between patients with dermal (100%) and subcutaneous (86%) LMS. All disease recurrences occurred in subcutaneous LMS (17% vs. 0%, p = .02) and subcutaneous tumors had a worse10‐year metastatic free survival (81% vs. 100%, p = .03). Conclusions The results of this study suggest that dermal LMS can be managed with a negative margin resection alone. Although the prognosis for patients with subcutaneous LMS is quite favorable, there is some risk for local and distant recurrence, and such patients will benefit from multidisciplinary care.
ISSN:0022-4790
1096-9098
DOI:10.1002/jso.26262