Primary cutaneous leiomyosarcoma: demographics and survival benefit of surgical management in a US population.

Background: Leiomyosarcoma of the skin is a rare malignant mesenchymal neoplasm categorized as cutaneous or subcutaneous. This study identified demographic and pathological factors affecting the prognosis and treatment of leiomyosarcoma of the skin.

Methods: Data of patients with skin leiomyosarcoma was extracted from 2000 to 2020 using the Surveillance, Epidemiology, and End Results database. Propensity score matching and prognostic nomograms were used to analyze survival rate predictions.

Results: Most patients were >65 years of age (50.5%), male (78.8%), and White (88.5%). The overall 5-year survival was 79.9% (95% confidence interval [CI] = 77.4-82.6), and the 5-year cause-specific survival rate was 95.7% (95% CI = 94.2-97.2). Based on treatment, the 5-year cause-specific survival rate was 82.9% (95% CI = 80.3-85.6) for surgery only, 60.2% (95% CI = 47.7-76.0) for both radiation and surgery, and 68.2% (95% CI = 58.9-78.9) for no treatment. Multivariable analysis showed that head and neck tumors were associated with worse mortality.

Conclusion: The results provide valuable insights that could shape development of future clinical protocols for skin leiomyosarcoma and impact patient care and treatment efficacy.