title: Clinical course of nonvisceral soft tissue leiomyosarcoma in 225 patients from the Scandinavian Sarcoma Group.
abstract: BACKGROUND
  Leiomyosarcoma of nonvisceral soft tissues is an uncommon malignant tumor; thus, only small numbers of cases have been reported. This study was based on a large series of patients from the Scandinavian Sarcoma Group Register acquired during a 15-year period (from 1986 to 2001). Follow-up information was available for all patients.
  
  
  METHODS
  The authors analyzed the clinical features of 225 patients with cutaneous, subcutaneous, or deep-seated leiomyosarcoma of the extremities, trunk wall, and superficial parts of the head and neck region to determine the natural course of the disease. Only patients who received their treatment at a specialist sarcoma center were included. Re-evaluation of histopathology was performed.
  
  
  RESULTS
  The age of the patients (121 women and 104 men) ranged from 20 years to 98 years (median, 70 years), and the tumors ranged in size from 0.6 cm to 35 cm (median, 4.0 cm). Eighty-two percent of the tumors were classified as high grade. The median follow-up for survivors was 5.5 years. The local treatment was adequate in 154 of 206 patients (75%) who were without metastasis at presentation. At 10 years, 84% of the 206 patients with localized disease at presentation were free from local recurrence, 66% remained metastasis free, and 49% were alive. Multivariate analysis showed that higher malignancy grade (P = .006), larger tumor size (P = .003), and deeper tumor location (P = .002) were correlated significantly with decreased metastasis-free survival, inadequate local treatment was correlated with local recurrence (P = .007), and high malignancy grade was correlated with decreased overall survival (P = .007).
  
  
  CONCLUSIONS
  The long-term prognosis for patients with subcutaneous and deep-seated soft tissue leiomyosarcoma remains poor despite the ability to achieve adequate local control through nonmutilating surgery with or without radiotherapy.
authors.affiliation: Department of Plastic Surgery, Helsinki University Central Hospital, Helsinki, Finland. catarina.svarvar@hus.fi
authors.forename: Catarina
authors.initials: C
authors.lastname: Svarvar
authors.forename: Tom
authors.initials: T
authors.lastname: Böhling
authors.forename: Orjan
authors.initials: O
authors.lastname: Berlin
authors.forename: Pelle
authors.initials: P
authors.lastname: Gustafson
authors.forename: Gunnar
authors.initials: G
authors.lastname: Follerås
authors.forename: Bodil
authors.initials: B
authors.lastname: Bjerkehagen
authors.forename: Henryk A
authors.initials: HA
authors.lastname: Domanski
authors.forename: Kirsten
authors.initials: K
authors.lastname: Sundby Hall
authors.forename: Erkki
authors.initials: E
authors.lastname: Tukiainen
authors.forename: Carl
authors.initials: C
authors.lastname: Blomqvist
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007890:Leiomyosarcoma / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012042:Registries / Q000706:statistics & numerical data; D012537:Scandinavian and Nordic Countries; D012983:Soft Tissue Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome