Gastrointestinal leiomyosarcoma demonstrate a predilection for distant recurrence and poor response to systemic treatments
Autor: | Khin Thway, Cyril Fisher, Alannah Smrke, Dirk C. Strauss, Paul H. Huang, Myles Smith, Magnus Hallin, Robin L. Jones, Andrew J. Hayes, Charlotte Benson, Christina Messiou |
---|---|
Rok vydání: | 2021 |
Předmět: |
Adult
Leiomyosarcoma Male 0301 basic medicine medicine.medical_specialty Neoplasms Radiation-Induced Antineoplastic Agents Kaplan-Meier Estimate Disease Localised disease Systemic therapy 03 medical and health sciences 0302 clinical medicine Antineoplastic Combined Chemotherapy Protocols Humans Medicine Aged Gastrointestinal Neoplasms Retrospective Studies Aged 80 and over Radiotherapy business.industry Soft tissue sarcoma Distant recurrence Metastasectomy Margins of Excision Cancer General Medicine Middle Aged medicine.disease Progression-Free Survival Surgery Survival Rate 030104 developmental biology Oncology Chemotherapy Adjuvant 030220 oncology & carcinogenesis Primary Leiomyosarcoma Female Neoplasm Recurrence Local business |
Zdroj: | European Journal of Surgical Oncology. 47:2595-2601 |
ISSN: | 0748-7983 |
DOI: | 10.1016/j.ejso.2021.04.043 |
Popis: | Background Primary leiomyosarcoma (LMS) of the gastrointestinal (GI) tract is rare. Limited literature exists regarding the clinical characteristics and outcome for patients with localised and metastatic disease. Methods A retrospective chart review was performed for patients greater than 18 years of age diagnosed with GI LMS at The Royal Marsden Hospital between 1 January 2000–1 May 2020. Descriptive statistics were performed. Patients were censored at data cut-off date of 27 June 2020. Results Forty-six patients with a median age at diagnosis of 54 years (range 25–85) were identified. Fifteen percent (n = 7) of patients previously received abdominal radiation for an unrelated cancer. All patients with localised disease (n = 36) had resection with oncological margins. For patients who underwent potentially curative surgery, median recurrence-free survival (mRFS) was 13 months (0.4–183 months), and half of these patients (n = 18) developed recurrent disease post resection (distant n = 16, local n = 2). Median overall survival (mOS) was 27 months for patients with distant recurrence. Twenty-one percent (n = 10) of patients presented with synchronous metastatic disease and their mOS was 19 months. Median progression-free survival (mPFS) for patients treated with conventional chemotherapy ranged from 2.0 to 8.0 months. Conclusion The risk of recurrence is significant, and recurrence-free survival was short even with complete oncologic resection. The relationship of prior abdominal radiotherapy to the development of GI LMS warrants further investigation. Outcomes with systemic therapy for metastatic disease were poor and there is a need for the development of more effective systemic therapies. |
Databáze: | OpenAIRE |
Externí odkaz: |