title: Prognostic factors and survival in patients treated surgically for recurrent metastatic uterine leiomyosarcoma.
abstract: BACKGROUND
  Uterine leiomyosarcoma (LMS) is a rare diagnosis, which is seldom cured when it recurs with metastatic disease. We evaluated patients who present with first time recurrence treated surgically to determine prognostic factors associated with long-term survival.
  
  
  METHODS
  Over a 16-year period, 41 patients were operated on for recurrent uterine sarcoma. Data examined included patient age, date of initial diagnosis, tumor histology, grade at the initial diagnosis, cytopathology changes in tumor activity from the initial diagnosis, residual tumor after all operations, use of adjuvant therapy, dates and sites of all recurrences, and disease status at last followup.
  
  
  RESULTS
  24 patients were operated for first recurrence of metastatic uterine LMS. Complete tumor resection with histologic negative margins was achieved in 16 (67%) patients. Overall survival was significantly affected by the FIGO stage at the time of the initial diagnosis, the ability to obtain complete tumor resection at the time of surgery for first time recurrent disease, single tumor recurrence, and recurrence greater than 12 months from the time of the initial diagnosis. Median disease-free survival was 14 months and overall survival was 27 months.
  
  
  CONCLUSIONS
  Our findings suggest that stage 1 at the time of initial diagnosis, recurrence greater than 12 months, isolated tumor recurrence, and the ability to remove ability to perform complete tumor resection at the time of the first recurrence can afford improved survival in selected patientsat the time of the first recurrence can afford improved survival in selected patients.
authors.affiliation: Department of Surgery, NYU Langone Medical Center, 560 First Avenue, Suite 6C, New York, NY 10016, USA.
authors.forename: Han L T
authors.initials: HL
authors.lastname: Hoang
authors.affiliation: NYU School of Medicine, 550 First Avenue, New York, NY 10016, USA.
authors.forename: Kelsey
authors.initials: K
authors.lastname: Ensor
authors.affiliation: Department of Medicine, NYU Langone Medical Center, 240 East 38th Street, FI 19, New York, NY 10016, USA.
authors.forename: Gerald
authors.initials: G
authors.lastname: Rosen
authors.affiliation: Department of Surgery, NYU Langone Medical Center, 560 First Avenue, Suite 6C, New York, NY 10016, USA.
authors.forename: H
authors.initials: H
authors.lastname: Leon Pachter
authors.affiliation: Department of Surgery, NYU Langone Medical Center, 560 First Avenue, Suite 6C, New York, NY 10016, USA.
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Raccuia
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007890:Leiomyosarcoma / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology; D014594:Uterine Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*