Prognosis and Follow-Up Recommendations for Subcutaneous and Dermal Leiomyosarcoma: Local Recurrence, Metastasis, and Overall Survival in a Danish Nationwide Cohort of 661 Patients.
Kiya Abebe, Mathias Ørholt, Erik E F Bak, Andreas Larsen, Anne Lene Wagenblast, Grethe Schmidt, David Hebbelstrup Jensen, Michael M Petersen, Anand C Loya, Søren Daugaard, Mikkel Herly, Jason L Hornick, Thomas Mentzel, Peter Vester-Glowinski
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引用次数: 0
Abstract
Background and objectives: The prognostic differences between subcutaneous leiomyosarcoma and dermal leiomyosarcoma are not well defined due to limited cohort sizes and insufficient follow-up in prior studies. This study aimed to investigate the clinicopathological features of subcutaneous and dermal leiomyosarcoma and estimate their 10-year rates of metastasis, local recurrence, and overall survival. Additionally, we propose standardized follow-up recommendations.
Methods: All patients diagnosed with cutaneous leiomyosarcoma in Denmark from 1980 to 2022 were included. The prognosis was estimated using age- and sex-standardized stratified cause-specific Cox-regression with all-cause mortality as competing risk.
Results: We included 196 patients with subcutaneous leiomyosarcoma and 465 with dermal leiomyosarcoma. The 10-year local recurrence rate was similar in patients with subcutaneous leiomyosarcoma (15%) and dermal leiomyosarcoma (11%, p = 0.13). However, patients with subcutaneous leiomyosarcoma had a significantly higher 10-year risk of metastasis (25%), primarily observed in grade 2 and 3 tumors, compared with dermal leiomyosarcoma (2.7%), p < 0.001, and a lower 10-year-overall survival (56% vs. 64%), p = 0.02.
Conclusions: Grade 2 and 3 subcutaneous leiomyosarcoma should be classified as a high-risk sarcoma with a substantial risk of metastasis and poor overall survival, necessitating follow-up that includes both clinical examinations and PET/CT or CT of the thorax for 5 years to detect both locoregional and distant metastases. Dermal leiomyosarcoma should be considered a low-risk sarcoma due to its low risk of metastasis and moderate risk of local recurrence, suggesting that the follow-up can focus on clinical examinations for 4 years as the 10-year risk of local recurrence is < 1% after this time point.
期刊介绍:
The Journal of Surgical Oncology offers peer-reviewed, original papers in the field of surgical oncology and broadly related surgical sciences, including reports on experimental and laboratory studies. As an international journal, the editors encourage participation from leading surgeons around the world. The JSO is the representative journal for the World Federation of Surgical Oncology Societies. Publishing 16 issues in 2 volumes each year, the journal accepts Research Articles, in-depth Reviews of timely interest, Letters to the Editor, and invited Editorials. Guest Editors from the JSO Editorial Board oversee multiple special Seminars issues each year. These Seminars include multifaceted Reviews on a particular topic or current issue in surgical oncology, which are invited from experts in the field.