title: Analysis of treatment failures in patients with early-stage uterine leiomyosarcoma.
abstract: This retrospective study aimed to investigate the treatment failures in 26 patients with stages I-II uterine leiomyosarcoma (> or = 10 mitoses per 10 high-power field (HPF) who underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy +/- adjuvant external pelvic irradiation. Thirteen (50%) patients developed recurrent disease, after a median time of 10 months from surgery (range = 4-72 months). Recurrence was pelvic in 3 (23%) patients, extrapelvic in 9 (69%) patients, and both pelvic and extrapelvic in 1 (8%) patient. Disease-free survival was better for premenopausal than for postmenopausal patients (p = 0.002) and for patients with < 20 mitoses per 10 HPF than for those with > or = 20 mitoses per 10 HPF (p = 0.006). In conclusion, patients with early-stage disease who had undergone locoregional treatment experienced a high recurrence rate. Most of the treatment failures were extrapelvic. Multicentric randomized trials on the role of adjuvant chemotherapy are advocated.
authors.affiliation: Department of Gynecology and Obstetrics, University of Pisa, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Gadducci
authors.forename: M G
authors.initials: MG
authors.lastname: Fabrini
authors.forename: A
authors.initials: A
authors.lastname: Bonuccelli
authors.forename: S
authors.initials: S
authors.lastname: Moda
authors.forename: A
authors.initials: A
authors.lastname: Fanucchi
authors.forename: M
authors.initials: M
authors.lastname: Laddaga
authors.forename: V
authors.initials: V
authors.lastname: Facchini
mesh_terms: D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007890:Leiomyosarcoma / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D008593:Menopause; D008940:Mitotic Index; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D010052:Ovariectomy; D018714:Radiotherapy, Adjuvant; D011882:Radiotherapy, High-Energy; D012189:Retrospective Studies; D017211:Treatment Failure; D014594:Uterine Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*