Hideki Tokunaga1, Fumiaki Takahashi2, Hiroki Yamamoto3, Tsuyoshi Honda4, Takafumi Watanabe5, Tadahiro Shoji6, Toru Sugiyama6, Hidekazu Yamada7, Tomoe Tando8, Kosuke Yoshinaga9, Satoko Kagabu10, Takeo Otsuki11, Shogo Kin12, Yoshihito Yokoyama13, Satoshige Wagatsuma14, Kazuyo Sato15, Hirokazu Sato16, Takashi Oishi17, Yuji Yoshida18, Tadashi Hayasaka19, Toshihiko Matsui20, Noriaki Imai21, Hidekazu Nishigori1, Hiroaki Shimokawa2,22, Nobuo Yaegashi1, Yoh Watanabe23,24. 1. Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-Ku, Sendai, Miyagi, 980-8574, Japan. 2. Clinical Research, Innovation and Education Center, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan. 3. Department of Obstetrics and Gynecology, Omagari Kousei Medical Center, 8-65 Omagaritori-machi, Daisen, Omagari, Akita, 014-0027, Japan. 4. Department of Obstetrics and Gynecology, Iwaki Kyoritsu Hospital, 16 Uchigomimaya-machi, Iwaki, Fukushima, 973-8402, Japan. 5. Department of Obstetrics and Gynecology, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan. 6. Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan. 7. Department of Gynecology, Miyagi Cancer Center, 47-1 Medeshimashiote, Natori, Miyagi, 981-1293, Japan. 8. Department of Obstetrics and Gynecology, Hirosaki National Hospital, 1 Tomino-cho, Hirosaki, Aomori, 036-8545, Japan. 9. Department of Obstetrics and Gynecology, Sendai Medical Center, 2-8-8 Miyagino, Miyagino-ku, Sendai, Miyagi, 983-8520, Japan. 10. Department of Obstetrics and Gynecology, Nakadori General Hospital, 3-15 Minamidorimisono-cho, Akita, Akita, 010-8577, Japan. 11. Department of Obstetrics and Gynecology, Sendai City Hospital, 1-1-1 Asutonagamachi, Taihaku-ku, Sendai, Miyagi, 982-8502, Japan. 12. Department of Obstetrics and Gynecology, Takeda General Hospital, 3-27 Yamaga-machi, Aizuwakamatsu, Fukushima, 965-8585, Japan. 13. Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan. 14. Department of Obstetrics and Gynecology, Osaki Citizen Hospital, 3-8-1 Furukawa, Osaki, Miyagi, 989-6183, Japan. 15. Department of Obstetrics and Gynecology, Iwate Prefectural Chubu Hospital, 17-10 Murasakino, Kitakami, Iwate, 024-8507, Japan. 16. Department of Obstetrics and Gynecology, Japanese Red Cross Akita Hospital, 222-1 Kamikitatesaruta, Akita, Akita, 010-1495, Japan. 17. Department of Obstetrics and Gynecology, Aomori Kousei Hospital, 488-1 Shinjyo, Aomori, Aomori, 038-0042, Japan. 18. Department of Obstetrics and Gynecology, Japanese Red Cross Ishinomaki Hospital, 71 Hebita, Ishinomaki, Miyagi, 986-8522, Japan. 19. Department of Obstetrics and Gynecology, Nihonkai General Hospital, 30 Akiho-cho, Sakata, Yamagata, 998-8501, Japan. 20. Department of Obstetrics and Gynecology, Noshiro Kousei Medical Center, Ochiai, Akita, Noshiro, 016-0014, Japan. 21. Department of Obstetrics and Gynecology, Hachinohe City Hospital, 1 Bisyamontai, Hachinohe, Aomori, Tamukai-aza, 031-8555, Japan. 22. Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-Ku, Sendai, Miyagi, 980-8574, Japan. 23. Clinical Research, Innovation and Education Center, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan. ywatanabe@hosp.tohoku-mpu.ac.jp. 24. Department of Obstetrics and Gynecology, Tohoku Medical and Pharmaceutical University, 1-12-1 Fukumuro, Miyagino-Ku, Sendai, Miyagi, 983-8512, Japan. ywatanabe@hosp.tohoku-mpu.ac.jp.
Abstract
BACKGROUND: To prepare for a future clinical trial for improving the long-term prognosis of patients with uterine leiomyosarcoma (ULMS), we conducted a multi-institutional survey in the Tohoku region of Japan. METHODS: We conducted a retrospective cohort study between 2011 and 2014 in member institutions of the Tohoku Translational Research Center Development Network. RESULTS: A total of 53 patients with ULMS were registered in 31 institutions for the present survey. The median patient age was 56 years, 67.9% of the patients were postmenopausal, 88.7% had a performance status of 0 or 1, and only 6 patients (11.3%) showed preoperative evidence of malignancy. Although retroperitoneal lymphadenectomy was performed in only 26.4% of patients, 64.2% patients were identified as having FIGO stage 1 disease; 73.6% were eligible to undergo complete surgery. Among 36 patients who were treated with postoperative chemotherapy, 28 (77.8%) received docetaxel and gemcitabine combination therapy. The most frequent recurrence site was the lungs, and the median progression-free survival of all enrolled patients was 11.7 months. However, the median progression-free survival and the median overall survival in patients with stages III and IV disease were 3.4 and 11.4 months, respectively. CONCLUSION: Although ULMS was associated with a high rate of complete or optimal surgery, the long-term prognosis was poor. Effective postoperative therapy should be developed to improve the long-term prognosis of patients with ULMS.
BACKGROUND: To prepare for a future clinical trial for improving the long-term prognosis of patients with uterine leiomyosarcoma (ULMS), we conducted a multi-institutional survey in the Tohoku region of Japan. METHODS: We conducted a retrospective cohort study between 2011 and 2014 in member institutions of the Tohoku Translational Research Center Development Network. RESULTS: A total of 53 patients with ULMS were registered in 31 institutions for the present survey. The median patient age was 56 years, 67.9% of the patients were postmenopausal, 88.7% had a performance status of 0 or 1, and only 6 patients (11.3%) showed preoperative evidence of malignancy. Although retroperitoneal lymphadenectomy was performed in only 26.4% of patients, 64.2% patients were identified as having FIGO stage 1 disease; 73.6% were eligible to undergo complete surgery. Among 36 patients who were treated with postoperative chemotherapy, 28 (77.8%) received docetaxel and gemcitabine combination therapy. The most frequent recurrence site was the lungs, and the median progression-free survival of all enrolled patients was 11.7 months. However, the median progression-free survival and the median overall survival in patients with stages III and IV disease were 3.4 and 11.4 months, respectively. CONCLUSION: Although ULMS was associated with a high rate of complete or optimal surgery, the long-term prognosis was poor. Effective postoperative therapy should be developed to improve the long-term prognosis of patients with ULMS.
Authors: Winette T A van der Graaf; Jean-Yves Blay; Sant P Chawla; Dong-Wan Kim; Binh Bui-Nguyen; Paolo G Casali; Patrick Schöffski; Massimo Aglietta; Arthur P Staddon; Yasuo Beppu; Axel Le Cesne; Hans Gelderblom; Ian R Judson; Nobuhito Araki; Monia Ouali; Sandrine Marreaud; Rachel Hodge; Mohammed R Dewji; Corneel Coens; George D Demetri; Christopher D Fletcher; Angelo Paolo Dei Tos; Peter Hohenberger Journal: Lancet Date: 2012-05-16 Impact factor: 79.321
Authors: Patrick Schöffski; Sant Chawla; Robert G Maki; Antoine Italiano; Hans Gelderblom; Edwin Choy; Giovanni Grignani; Veridiana Camargo; Sebastian Bauer; Sun Young Rha; Jean-Yves Blay; Peter Hohenberger; David D'Adamo; Matthew Guo; Bartosz Chmielowski; Axel Le Cesne; George D Demetri; Shreyaskumar R Patel Journal: Lancet Date: 2016-02-10 Impact factor: 79.321
Authors: Robert L Giuntoli; Daniel S Metzinger; Connie S DiMarco; Stephen S Cha; Jeff A Sloan; Gary L Keeney; Bobbie S Gostout Journal: Gynecol Oncol Date: 2003-06 Impact factor: 5.482
Authors: Christine Garcia; Jenna S Kubat; Regan S Fulton; Adam T Anthony; Mary Combs; C Bethan Powell; Ramey D Littell Journal: Int J Gynecol Cancer Date: 2015-05 Impact factor: 3.437
Authors: Jose Alejandro Rauh-Hain; Titilope Oduyebo; Elisabeth J Diver; Stephanie H Guseh; Suzanne George; Micheal G Muto; Marcela G del Carmen Journal: Int J Gynecol Cancer Date: 2013-07 Impact factor: 3.437
Authors: Martee L Hensley; J Kyle Wathen; Robert G Maki; Dejka M Araujo; Gregory Sutton; Dennis A Priebat; Suzanne George; Robert A Soslow; Laurence H Baker Journal: Cancer Date: 2013-01-18 Impact factor: 6.860
Authors: Martee L Hensley; Nicole Ishill; Robert Soslow; Joseph Larkin; Nadeem Abu-Rustum; Paul Sabbatini; Jason Konner; William Tew; David Spriggs; Carol A Aghajanian Journal: Gynecol Oncol Date: 2009-01-09 Impact factor: 5.482
Authors: Martee L Hensley; John A Blessing; Koen Degeest; Ovadia Abulafia; Peter G Rose; Howard D Homesley Journal: Gynecol Oncol Date: 2008-04-18 Impact factor: 5.482