title: Immunohistochemical expression of estrogen and progesterone receptors and outcomes in patients with newly diagnosed uterine leiomyosarcoma.
abstract: OBJECTIVE
  We assessed the IHC expression of ER and PR and their prognostic significance in uterine leiomyosarcoma (LMS).
  
  
  METHODS
  We identified 43 "high-grade" uterine LMS cases from 7/82-7/07 for whom ER/PR IHC analysis was performed at initial diagnosis at our institution.
  
  
  RESULTS
  Disease was confined to the uterine body in 20/43 (47%). Eighteen (42%) of 43 were ER(+); 17/42 (41%) were PR(+). At last follow-up, 33 (77%) had recurred or progressed, and 23 (54%) had died. PR expression was associated with improved progression-free survival (PFS; P=0.002) and overall survival (OS; P=0.03) overall; ER expression was not. After adjusting for stage, ER expression was associated with PFS (P=0.01), not OS (P=0.3), and PR expression maintained a significant association with PFS (P=0.002) and approached a significant association with OS (P=0.05). Neither ER nor PR expression was associated with outcome in cases with disease outside the uterine body. In cases with confined disease, median PFS for ER(+) or PR(+) cases was not reached compared to 16.9 months for ER(-) cases (95% CI: 8.1-25.7; P=0.03) and 13.5 months for PR(-) cases (95% CI: 5.9-21.1; P=0.001). Only 1/10 PR(+) cases recurred and died; 9/10 PR(-) cases recurred, and 5 died. Two of 9 ER(+) cases recurred and died; 8/11 ER(-) cases recurred, and 4 died.
  
  
  CONCLUSIONS
  ER/PR expression is associated with survival outcomes in patients with high-grade uterine LMS confined to the uterine body. PR expression seems capable of identifying cases confined to the uterine body, which have better outcomes.
authors.affiliation: Departments of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA. gynbreast@mskcc.org
authors.forename: Mario M
authors.initials: MM
authors.lastname: Leitao
authors.forename: Martee L
authors.initials: ML
authors.lastname: Hensley
authors.forename: Richard R
authors.initials: RR
authors.lastname: Barakat
authors.forename: Carol
authors.initials: C
authors.lastname: Aghajanian
authors.forename: Ginger J
authors.initials: GJ
authors.lastname: Gardner
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Jewell
authors.forename: Roisin
authors.initials: R
authors.lastname: O'Cearbhaill
authors.forename: Robert A
authors.initials: RA
authors.lastname: Soslow
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007890:Leiomyosarcoma / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011960:Receptors, Estrogen / Q000096:biosynthesis*; D011980:Receptors, Progesterone / Q000096:biosynthesis*; D015996:Survival Rate; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000601:surgery
chemical_list: D011960:Receptors, Estrogen; D011980:Receptors, Progesterone