title: Outcomes after surgery for spinal metastatic leiomyosarcoma.
abstract: OBJECTIVE
  Leiomyosarcoma is a smooth-muscle sarcoma that rarely metastasizes to the spine. Its clinical course is variable, although patients with metastatic leiomyosarcoma can experience prolonged survival as compared with patients with more aggressive metastatic tumors. The authors report their single-institution experience in the surgical treatment of patients with leiomyosarcoma metastatic to the spine.
  
  
  METHODS
  A retrospective review of the electronic medical records was performed to obtain details on clinical management and outcomes for patients who had undergone surgical intervention for metastatic leiomyosarcoma of the spine. The few articles available in the current literature on this topic were also analyzed.
  
  
  RESULTS
  Eight patients with metastatic leiomyosarcoma of the spine underwent surgical management between 2005 and 2011. Six patients (75%) had improvement in their Nurick grade. Patients who had presented with pain as a primary symptom experienced significant relief. Five patients (63%) had lesion recurrence, and 4 underwent repeat surgery at a mean of 10.2 months after their initial surgery. The mean duration of survival was 11.7 months (range 3.3-23.0 months).
  
  
  CONCLUSIONS
  Leiomyosarcoma rarely metastasizes to the spine. However, surgical intervention can relieve pain and improve neurological function. Given the potential for prolonged survival, aggressive management should be considered in well-selected patients.
authors.affiliation: Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, Michigan 48109-5338, USA.
authors.forename: John E
authors.initials: JE
authors.lastname: Ziewacz
authors.forename: Darryl
authors.initials: D
authors.lastname: Lau
authors.forename: Frank
authors.initials: F
authors.lastname: La Marca
authors.forename: Paul
authors.initials: P
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D007890:Leiomyosarcoma / Q000175:diagnosis / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D012189:Retrospective Studies; D013125:Spinal Neoplasms / Q000175:diagnosis / Q000556:secondary / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome