Cutaneous leiomyosarcoma: treatment and outcomes with a standardized margin of resection.
BACKGROUND
Cutaneous leiomyosarcoma is primarily a low-grade malignancy that affects elderly male Caucasians. It is a rare dermal-based tumor for which treatment algorithms have been poorly defined.


METHODS
We retrospectively reviewed the use of a median 1-cm margin for resection to treat patients with cutaneous leiomyosarcoma referred for treatment between 2005 and 2010.


RESULTS
Thirty-three patients with cutaneous leiomyosarcoma were treated. Of these, 76% were male, 97% were Caucasian (median age: 63.5 years), and 67% of tumors were located on the extremities. Preoperative staging was negative for distant metastasis in all patients. A majority of the tumors (88%) were low grade (median size: 1.3 cm). All of the tumors were positive for smooth-muscle actin. A total of 94% of patients underwent primary surgical resection with a median margin of 1 cm. Final resection margin was negative in 97% of patients. Adjuvant radiotherapy was used in 15%. No metastatic spread or recurrences were present, and 100% of patients were alive at last follow-up (median: 15.5 months).


CONCLUSIONS
Good oncological control and excellent outcomes are possible with a 1-cm resection margin in most cases of cutaneous leiomyosarcoma.
Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA. Jonathan.Zager@Moffitt.org.
Jeremiah L
JL
Deneve
Jane L
JL
Messina
Marilyn M
MM
Bui
Suroosh S
SS
Marzban
G Douglas
GD
Letson
David
D
Cheong
Ricardo J
RJ
Gonzalez
Vernon K
VK
Sondak
Jonathan S
JS
Zager
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007890:Leiomyosarcoma / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult