title: Postoperative radiotherapy improves local control and survival in patients with uterine leiomyosarcoma.
abstract: BACKGROUND
  To examine the role of radiotherapy (RT) in uterine leiomyosarcomas (LMS) and to determine the patient population who may benefit from RT.
  
  
  METHODS
  From 1998-2008, 69 patients with primary uterine LMS underwent hysterectomy with or without pelvic radiotherapy to a median dose of 45 Gy. Univariate analysis was performed using the Kaplan-Meier method and cumulative-incidence function, and multivariate analyses using Fine and Gray or Cox proportional hazard models.
  
  
  RESULTS
  Following surgery, 32 out of 69 patients received RT. There was no evidence of any correlation between patient, disease and treatment characteristics and the use of RT. Median follow-up was 57 months. RT was associated with reduced local recurrence (3y LR 19% vs. 39%; Gray's p = 0.019) and improved overall survival (3y OS 69% vs. 35%; log-rank p = 0.025) on univariate analysis. Multivariate analysis demonstrated that RT reduced LR (HR: 0.28, CI: 0.11-0.69, p = 0.006) and increased OS (HR: 0.44, CI: 0.23-0.85, p = 0.014) independent of other clinical and pathologic factors. Positive surgical margins increased the odds of LR (HR: 5.6, CI: 2.3-13.4, p = 0.00012). Large tumor size and advanced stage (II-IV) were associated with the development of distant metastases and inferior OS.
  
  
  CONCLUSIONS
  Postoperative pelvic RT reduces LR and improves OS of patients with uterine LMS.
authors.forename: Philip
authors.initials: P
authors.lastname: Wong
authors.forename: Kathy
authors.initials: K
authors.lastname: Han
authors.forename: Jenna
authors.initials: J
authors.lastname: Sykes
authors.forename: Charles
authors.initials: C
authors.lastname: Catton
authors.forename: Stephane
authors.initials: S
authors.lastname: Laframboise
authors.forename: Anthony
authors.initials: A
authors.lastname: Fyles
authors.forename: Lee
authors.initials: L
authors.lastname: Manchul
authors.forename: Wilfred
authors.initials: W
authors.lastname: Levin
authors.forename: Michael
authors.initials: M
authors.lastname: Milosevic
mesh_terms: D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007890:Leiomyosarcoma / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D008875:Middle Aged; D018714:Radiotherapy, Adjuvant; D014594:Uterine Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery