Prognosticators and the role of lymphadenectomy in uterine leiomyosarcomas

Arch Gynecol Obstet. 2009 Jul;280(1):79-85. doi: 10.1007/s00404-008-0876-0. Epub 2008 Dec 19.

Abstract

Objective: To analyze prognostic factors, the role of lymphadenectomy and postoperative adjuvant treatments in patients with uterine leiomyosarcomas (LMS).

Study design: Sixty-three patients with uterine LMS are retrospectively analyzed with respect to both DFS and OS.

Results: Multivariate DFS analysis revealed percentage necrosis to be the unique factor to be significant (median DFS was 3.31 years for <25% necrosis and 0.78 for >25% necrosis). Multivariate analysis revealed the mitotic counts to be the unique significant factor affecting the OS (median OS was 7.20 and 1.73 years, respectively, for patients with mitotic counts of 1-5 and >6; respectively). Median DFS was 2.51 years for patients who had undergone lymphadenectomy and 2.36 years for remaining who did not have a lymphadenectomy procedure (P = 0.4). With respect to OS, median values were 2.44 and 3.16 years, respectively (P = 0.7). Number of the resected lymph nodes was also not significant for both OS and DFS.

Conclusions: Mitotic counts and percentage necrosis have significant effects on OS and DFS; respectively. Neither the performance nor the extent of lymphadenectomy has an effect on patient survival.

MeSH terms

  • Disease-Free Survival
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Leiomyosarcoma* / mortality
  • Leiomyosarcoma* / pathology
  • Leiomyosarcoma* / surgery
  • Lymph Node Excision / statistics & numerical data*
  • Lymphatic Metastasis
  • Middle Aged
  • Mitotic Index
  • Multivariate Analysis
  • Necrosis
  • Prognosis
  • Regression Analysis
  • Retrospective Studies
  • Survival Analysis
  • Uterine Neoplasms* / mortality
  • Uterine Neoplasms* / pathology
  • Uterine Neoplasms* / surgery