Treatment outcome of superficial leiomyosarcoma

• 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
• ISSN: 0022-4790; 1096-9098
• DOI: 10.1002/jso.26262

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.