title: Distinctive outcome in patients with non-uterine and uterine leiomyosarcoma.
abstract: BACKGROUND
  Leiomyosarcomas represent the largest subtype of soft tissue sarcomas. Two subgroups can be distinguished, non-uterine (NULMS) and uterine leiomyosarcomas (ULMS). The aim of this retrospective study was to evaluate differences in clinical features and outcome between these two subgroups.
  
  
  METHODS
  Outcome and clinical-pathological parameters between 50 patients with NULMS and 45 patients with ULMS were assessed, and compared between both groups. Univariate and multivariable survival analyses were performed.
  
  
  RESULTS
  Patients with ULMS presented with larger tumors when compared to patients with NULMS (p < 0.001). More patients with ULMS initially presented with metastatic disease (67% vs. 36%, p = 0.007). Most common metastatic site was lung for both subtypes (28% and 38%). Five-year overall survival (OS) rates of 82.6% and 41.2% and median OS times of 92.6 (range: 79.7-105.4) and 50.4 (range: 34.8-66.0) months were observed in patients with NULMS and ULMS, respectively (p = 0.006). In multivariate analysis, initial metastatic disease remained an independent prognostic factor in terms of OS (p < 0.0001).
  
  
  CONCLUSIONS
  At time of diagnosis ULMS were larger and more often metastasized. Therefore patients with ULMS showed unfavorable outcome when compared to NULMS. Later diagnosis might be caused by differences in symptoms and clinical presentation or a more aggressive biological tumor behavior.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Lamm
authors.forename: Camilla
authors.initials: C
authors.lastname: Natter
authors.forename: Sophie
authors.initials: S
authors.lastname: Schur
authors.forename: Wolfgang J
authors.initials: WJ
authors.lastname: Köstler
authors.forename: Alexander
authors.initials: A
authors.lastname: Reinthaller
authors.forename: Michael
authors.initials: M
authors.lastname: Krainer
authors.forename: Christoph
authors.initials: C
authors.lastname: Grimm
authors.forename: Reinhard
authors.initials: R
authors.lastname: Horvath
authors.forename: Gabriele
authors.initials: G
authors.lastname: Amann
authors.forename: Philipp
authors.initials: P
authors.lastname: Funovics
authors.forename: Thomas
authors.initials: T
authors.lastname: Brodowicz
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Medical University of Vienna, 18-20 Waehringer Guertel, 1090 Vienna, Austria. stephan.polterauer@meduniwien.ac.at.
authors.forename: Stephan
authors.initials: S
authors.lastname: Polterauer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007890:Leiomyosarcoma / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D063868:Patient Outcome Assessment; D011379:Prognosis; D012189:Retrospective Studies; D012509:Sarcoma / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology* / Q000628:therapy