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Leiomyosarcoma

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Management of Soft Tissue Sarcoma

Abstract

Leiomyosarcoma (LMS) is one of the most common forms of soft tissue sarcoma, with approximately 2500 cases per year in the United States in 2015. The age distribution of adult leiomyosarcoma is presented in Fig. 6.1.

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References

  1. Guillou L, Aurias A. Soft tissue sarcomas with complex genomic profiles. Virchows Arch. 2010;456:201–17.

    Article  CAS  PubMed  Google Scholar 

  2. Meza-Zepeda LA, Kresse SH, Barragan-Polania AH, et al. Array comparative genomic hybridization reveals distinct DNA copy number differences between gastrointestinal stromal tumors and leiomyosarcomas. Cancer Res. 2006;66:8984–93.

    Article  CAS  PubMed  Google Scholar 

  3. Sandberg AA. Updates on the cytogenetics and molecular genetics of bone and soft tissue tumors: leiomyosarcoma. Cancer Genet Cytogenet. 2005;161:1–19.

    Article  PubMed  Google Scholar 

  4. Liau JY, Tsai JH, Jeng YM, et al. Leiomyosarcoma with alternative lengthening of telomeres is associated with aggressive histologic features, loss of ATRX expression, and poor clinical outcome. Am J Surg Pathol. 2015;39:236–44.

    Article  PubMed  Google Scholar 

  5. Yang CY, Liau JY, Huang WJ, et al. Targeted next-generation sequencing of cancer genes identified frequent TP53 and ATRX mutations in leiomyosarcoma. Am J Transl Res. 2015;7:2072–81.

    PubMed  PubMed Central  Google Scholar 

  6. Miettinen M, Fetsch JF. Evaluation of biological potential of smooth muscle tumours. Histopathology. 2006;48:97–105.

    Article  CAS  PubMed  Google Scholar 

  7. Juang CM, Yen MS, Horng HC, et al. Potential role of preoperative serum CA125 for the differential diagnosis between uterine leiomyoma and uterine leiomyosarcoma. Eur J Gynaecol Oncol. 2006;27:370–4.

    CAS  PubMed  Google Scholar 

  8. Folpe AL, Mentzel T, Lehr HA, et al. Perivascular epithelioid cell neoplasms of soft tissue and gynecologic origin: a clinicopathologic study of 26 cases and review of the literature. Am J Surg Pathol. 2005;29:1558–75.

    Article  PubMed  Google Scholar 

  9. Hollenbeck ST, Grobmyer SR, Kent KC, et al. Surgical treatment and outcomes of patients with primary inferior vena cava leiomyosarcoma. J Am Coll Surg. 2003;197:575–9.

    Article  PubMed  Google Scholar 

  10. Suzman MS, Smith AJ, Brennan MF. Fascio-peritoneal patch repair of the IVC: a workhorse in search of work? J Am Coll Surg. 2000;191:218–20.

    Article  CAS  PubMed  Google Scholar 

  11. Reed NS, Mangioni C, Malmstrom H, et al. Phase III randomised study to evaluate the role of adjuvant pelvic radiotherapy in the treatment of uterine sarcomas stages I and II: an European Organisation for Research and Treatment of Cancer Gynaecological Cancer Group Study (protocol 55874). Eur J Cancer. 2008;44:808–18.

    Article  CAS  PubMed  Google Scholar 

  12. Wright JD, Seshan VE, Shah M, et al. The role of radiation in improving survival for early-stage carcinosarcoma and leiomyosarcoma. Am J Obstet Gynecol 2008;199:536e1–8.

    Google Scholar 

  13. Sampath S, Schultheiss TE, Ryu JK, et al. The role of adjuvant radiation in uterine sarcomas. Int J Radiat Oncol Biol Phys. 2010;76:728–34.

    Article  PubMed  Google Scholar 

  14. Omura GA, Blessing JA, Major F, et al. A randomized clinical trial of adjuvant adriamycin in uterine sarcomas: a Gynecologic Oncology Group Study. J Clin Oncol. 1985;3:1240–5.

    CAS  PubMed  Google Scholar 

  15. Hensley ML, Ishill N, Soslow R, et al. Adjuvant gemcitabine plus docetaxel for completely resected stages I-IV high grade uterine leiomyosarcoma: results of a prospective study. Gynecol Oncol. 2009;112:563–7.

    Article  CAS  PubMed  Google Scholar 

  16. Hensley ML, Wathen K, Maki RG, et al. Adjuvant treatment of high-risk primary uterine leiomyosarcoma with gemcitabine/docetaxel, followed by doxorubicin: results of phase II multicenter trial SARC005. J Clin Oncol 2010;28:abstr 10021.

    Google Scholar 

  17. Hensley ML. Role of chemotherapy and biomolecular therapy in the treatment of uterine sarcomas. Best Pract Res Clin Obstet Gynaecol. 2011;25:773–82.

    Article  PubMed  Google Scholar 

  18. Gladdy RA, Qin LX, Moraco N, et al. Predictors of survival and recurrence in primary leiomyosarcoma. Ann Surg Oncol. 2013;20:1851–7.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Borden EC, Amato DA, Rosenbaum C, et al. Randomized comparison of three adriamycin regimens for metastatic soft tissue sarcomas. J Clin Oncol. 1987;5:840–50.

    CAS  PubMed  Google Scholar 

  20. Edmonson JH, Ryan LM, Blum RH, et al. Randomized comparison of doxorubicin alone versus ifosfamide plus doxorubicin or mitomycin, doxorubicin, and cisplatin against advanced soft tissue sarcomas. J Clin Oncol. 1993;11:1269–75.

    CAS  PubMed  Google Scholar 

  21. Sleijfer S, Ouali M, van Glabbeke M, et al. Prognostic and predictive factors for outcome to first-line ifosfamide-containing chemotherapy for adult patients with advanced soft tissue sarcomas: an exploratory, retrospective analysis on large series from the European Organization for Research and Treatment of Cancer-Soft Tissue and Bone Sarcoma Group (EORTC-STBSG). Eur J Cancer. 2010;46:72–83.

    Article  CAS  PubMed  Google Scholar 

  22. Gottlieb JA, Benjamin RS, Baker LH, et al. Role of DTIC (NSC-45388) in the chemotherapy of sarcomas. Cancer Treat Rep. 1976;60:199–203.

    CAS  PubMed  Google Scholar 

  23. Talbot SM, Keohan ML, Hesdorffer M, et al. A phase II trial of temozolomide in patients with unresectable or metastatic soft tissue sarcoma. Cancer. 2003;98:1942–6.

    Article  CAS  PubMed  Google Scholar 

  24. Zalupski M, Metch B, Balcerzak S, et al. Phase III comparison of doxorubicin and dacarbazine given by bolus versus infusion in patients with soft-tissue sarcomas: a Southwest Oncology Group study. J Natl Cancer Inst. 1991;83:926–32.

    Article  CAS  PubMed  Google Scholar 

  25. Omura GA, Major FJ, Blessing JA, et al. A randomized study of adriamycin with and without dimethyl triazenoimidazole carboxamide in advanced uterine sarcomas. Cancer. 1983;52:626–32.

    Article  CAS  PubMed  Google Scholar 

  26. Botsis D, Koliopoulos C, Kondi-Pafitis A, et al. Myxoid leiomyosarcoma of the uterus in a patient receiving tamoxifen therapy: a case report. Int J Gynecol Pathol. 2006;25:173–5.

    Article  PubMed  Google Scholar 

  27. Yildirim Y, Inal MM, Sanci M, et al. Development of uterine sarcoma after tamoxifen treatment for breast cancer: report of four cases. Int J Gynecol Cancer. 2005;15:1239–42.

    Article  CAS  PubMed  Google Scholar 

  28. Sabatini R, Di Fazio F, Loizzi P. Uterine leiomyosarcoma in a postmenopausal woman treated with tamoxifen: case report. Eur J Gynaecol Oncol. 1999;20:327–8.

    CAS  PubMed  Google Scholar 

  29. McCluggage WG, Varma M, Weir P, et al. Uterine leiomyosarcoma in patient receiving tamoxifen therapy. Acta Obstet Gynecol Scand. 1996;75:593–5.

    Article  CAS  PubMed  Google Scholar 

  30. O’Cearbhaill R, Zhou Q, Iasonos A, et al. Treatment of advanced uterine leiomyosarcoma with aromatase inhibitors. Gynecol Oncol. 2010;116:424–9.

    Article  PubMed  Google Scholar 

  31. Antman K, Crowley J, Balcerzak SP, et al. An intergroup phase III randomized study of doxorubicin and dacarbazine with or without ifosfamide and mesna in advanced soft tissue and bone sarcomas. J Clin Oncol. 1993;11:1276–85.

    CAS  PubMed  Google Scholar 

  32. Van Glabbeke M, Verweij J, Judson I, et al. Progression-free rate as the principal end-point for phase II trials in soft-tissue sarcomas. Eur J Cancer. 2002;38:543–9.

    Article  PubMed  Google Scholar 

  33. Bay JO, Ray-Coquard I, Fayette J, et al. Docetaxel and gemcitabine combination in 133 advanced soft-tissue sarcomas: a retrospective analysis. Int J Cancer. 2006;119:706–11.

    Article  CAS  PubMed  Google Scholar 

  34. Hensley ML, Blessing JA, Degeest K, et al. Fixed-dose rate gemcitabine plus docetaxel as second-line therapy for metastatic uterine leiomyosarcoma: a Gynecologic Oncology Group phase II study. Gynecol Oncol. 2008;109:323–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Hensley ML, Blessing JA, Mannel R, et al. Fixed-dose rate gemcitabine plus docetaxel as first-line therapy for metastatic uterine leiomyosarcoma: a Gynecologic Oncology Group phase II trial. Gynecol Oncol. 2008;109:329–34.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Hensley ML, Maki R, Venkatraman E, et al. Gemcitabine and docetaxel in patients with unresectable leiomyosarcoma: results of a phase II trial. J Clin Oncol. 2002;20:2824–31.

    Article  CAS  PubMed  Google Scholar 

  37. Leu KM, Ostruszka LJ, Shewach D, et al. Laboratory and clinical evidence of synergistic cytotoxicity of sequential treatment with gemcitabine followed by docetaxel in the treatment of sarcoma. J Clin Oncol. 2004;22:1706–12.

    Article  CAS  PubMed  Google Scholar 

  38. Maki RG, Wathen JK, Patel SR, et al. Randomized phase II study of gemcitabine and docetaxel compared with gemcitabine alone in patients with metastatic soft tissue sarcomas: results of sarcoma alliance for research through collaboration study 002 [corrected]. J Clin Oncol. 2007;25:2755–63.

    Article  CAS  PubMed  Google Scholar 

  39. Look KY, Sandler A, Blessing JA, et al. Phase II trial of gemcitabine as second-line chemotherapy of uterine leiomyosarcoma: a Gynecologic Oncology Group (GOG) Study. Gynecol Oncol. 2004;92:644–7.

    Article  CAS  PubMed  Google Scholar 

  40. Okuno S, Edmonson J, Mahoney M, et al. Phase II trial of gemcitabine in advanced sarcomas. Cancer. 2002;94:3225–9.

    Article  CAS  PubMed  Google Scholar 

  41. Okuno S, Ryan LM, Edmonson JH, et al. Phase II trial of gemcitabine in patients with advanced sarcomas (E1797): a trial of the Eastern Cooperative Oncology Group. Cancer. 2003;97:1969–73.

    Article  CAS  PubMed  Google Scholar 

  42. Duffaud F, Bui BN, Penel N, et al. A FNCLCC French Sarcoma Group—GETO multicenter randomized phase II study of gemcitabine versus gemcitabine and docetaxel in patients with metastatic or relapsed leiomyosarcoma. J Clin Oncol 2008;26:Abstr 10511.

    Google Scholar 

  43. Dileo P, Morgan JA, Zahrieh D, et al. Gemcitabine and vinorelbine combination chemotherapy for patients with advanced soft tissue sarcomas: results of a phase II trial. Cancer. 2007;109:1863–9.

    Article  CAS  PubMed  Google Scholar 

  44. Garcia-Del-Muro X, Lopez-Pousa A, Maurel J, et al. Randomized phase II study comparing gemcitabine plus dacarbazine versus dacarbazine alone in patients with previously treated soft tissue sarcoma: a Spanish Group for Research on Sarcomas study. J Clin Oncol. 2011;29:2528–33.

    Article  CAS  PubMed  Google Scholar 

  45. Amant F, Coosemans A, Renard V, et al. Clinical outcome of ET-743 (Trabectedin; Yondelis) in high-grade uterine sarcomas: report on five patients and a review of the literature. Int J Gynecol Cancer. 2009;19:245–8.

    Article  PubMed  Google Scholar 

  46. Demetri GD, Chawla SP, von Mehren M, et al. Efficacy and safety of trabectedin in patients with advanced or metastatic liposarcoma or leiomyosarcoma after failure of prior anthracyclines and ifosfamide: results of a randomized phase II study of two different schedules. J Clin Oncol. 2009;27:4188–96.

    Article  CAS  PubMed  Google Scholar 

  47. Tewari D, Saffari B, Cowan C, et al. Activity of trabectedin (ET-743, Yondelis) in metastatic uterine leiomyosarcoma. Gynecol Oncol. 2006;102:421–4.

    Article  CAS  PubMed  Google Scholar 

  48. Grosso F, Jones RL, Demetri GD, et al. Efficacy of trabectedin (ecteinascidin-743) in advanced pretreated myxoid liposarcomas: a retrospective study. Lancet Oncol. 2007;8:595–602.

    Article  CAS  PubMed  Google Scholar 

  49. Demetri GD, von Mehren M, Jones RL, et al. Efficacy and safety of trabectedin or dacarbazine for metastatic liposarcoma or leiomyosarcoma after failure of conventional chemotherapy: results of a phase III randomized multicenter clinical trial. J Clin Oncol. 2016;34:786–93.

    Article  CAS  PubMed  Google Scholar 

  50. Schoffski P, Chawla S, Maki RG, et al. Eribulin versus dacarbazine in previously treated patients with advanced liposarcoma or leiomyosarcoma: a randomised, open-label, multicentre, phase 3 trial. Lancet. 2016;387:1629–37.

    Article  CAS  PubMed  Google Scholar 

  51. van der Graaf WT, Blay JY, Chawla SP, et al. Pazopanib for metastatic soft-tissue sarcoma (PALETTE): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet. 2012;379:1879–86.

    Article  PubMed  Google Scholar 

  52. D’Adamo DR, Anderson SE, Albritton K, et al. Phase II study of doxorubicin and bevacizumab for patients with metastatic soft-tissue sarcomas. J Clin Oncol. 2005;23:7135–42.

    Article  PubMed  Google Scholar 

  53. Hensley ML, Miller A, O’Malley DM, et al. Randomized phase III trial of gemcitabine plus docetaxel plus bevacizumab or placebo as first-line treatment for metastatic uterine leiomyosarcoma: an NRG Oncology/Gynecologic Oncology Group study. J Clin Oncol. 2015;33:1180–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. International Center Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Murray F. Brennan MD

  2. Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Cristina R. Antonescu MD

  3. Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Kaled M. Alektiar MD

  4. Monter Cancer Center, Hofstra Northwell School of Medicine and Cold Spring Harbor Laboratory, Lake Success, NY, USA

    Robert G. Maki MD, PhD

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  1. Murray F. Brennan MD
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  2. Cristina R. Antonescu MD
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  3. Kaled M. Alektiar MD
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  4. Robert G. Maki MD, PhD
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Brennan, M.F., Antonescu, C.R., Alektiar, K.M., Maki, R.G. (2016). Leiomyosarcoma. In: Management of Soft Tissue Sarcoma. Springer, Cham. https://doi.org/10.1007/978-3-319-41906-0_6

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  • DOI: https://doi.org/10.1007/978-3-319-41906-0_6

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