title: Does Lymphadenectomy Improve Survival in Uterine Leiomyosarcoma?
abstract: BACKGROUND
  The role of lymphadenectomy in the management of uterine leiomyosarcoma (LMS) is controversial. We aimed to identify whether lymph node dissection (LND) has any survival benefit in uterine LMS.
  
  
  METHODS
  Data of 95 patients with histologically proven uterine LMS from 2 tertiary centers (1993 through 2009) were retrospectively analyzed. Kaplan-Meier and Cox proportional hazards regression models were used for analyses.
  
  
  RESULTS
  Mean age was 51.5 years. Thirty-six (37.9%) underwent LND. The median lymph node count was 54. Eight (22.2%) patients had lymphatic metastasis. Median follow-up was 26 months. Sixty-two (65%) patients had recurrence and 48 (50.5%) died. Median disease-free survival (DFS) was 19 months for both group of patients who had or did not have LND, and median overall survival (OS) was 29 and 26 months, respectively (P = 0.4). Five-year DFS was 35.9% vs 26.8% (P = 0.4), and 5-year OS was 45.4% vs 43.8% (P = 0.22) for the groups. Multivariate analyses did not reveal a single independent prognostic factor in respect to DFS or OS.
  
  
  CONCLUSIONS
  Higher rate of lymph node metastasis in patients with extrauterine disease indicated the importance of LND in LMS. However, the survival benefit of lymphadenectomy could not be shown.
authors: *Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Turkey; and †Department of Gynecologic Oncology, Ankara University School of Medicine, Ankara, Turkey; and ‡Department of Pathology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Turkey.
authors: Tolga
authors: T
authors: Tasci
authors: Alper
authors: A
authors: Karalok
authors: Salih
authors: S
authors: Taskin
authors: Isin
authors: I
authors: Ureyen
authors: Gunsu
authors: G
authors: Kımyon
authors: Firat
authors: F
authors: Tulek
authors: Ahmet
authors: A
authors: Ozfuttu
authors: Taner
authors: T
authors: Turan
authors: Gokhan
authors: G
authors: Tulunay
authors: M Faruk
authors: MF
authors: Kose
authors: Firat
authors: F
authors: Ortac
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007890:Leiomyosarcoma / Q000401:mortality* / Q000556:secondary / Q000601:surgery; D008197:Lymph Node Excision / Q000401:mortality*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D062606:Tertiary Care Centers; D014594:Uterine Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery