Uterine Leiomyosarcoma Management, Outcome, and Associated Molecular Biomarkers: A Single Institution’s Experience View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2013-07

AUTHORS

Kristelle Lusby, Kari Brewer Savannah, Elizabeth G. Demicco, Yiqun Zhang, Markus PH. Ghadimi, Eric D. Young, Chiara Colombo, Ryan Lam, Tugce E. Dogan, Jason L. Hornick, Alexander J. Lazar, Kelly K. Hunt, Matthew L. Anderson, Chad J. Creighton, Dina Lev, Raphael E. Pollock

ABSTRACT

BACKGROUND: Uterine leiomyosarcoma (ULMS) is an aggressive, rapidly progressive tumor lacking clinical and molecular predictors of outcome. METHODS: ULMS patients (n = 349) were classified by disease status at presentation to MDACC as having intra-abdominal (n = 157) or distant metastatic disease (n = 192). Patient, tumor, treatment, and outcome variables were retrospectively retrieved. Formalin-fixed, paraffin-embedded tumor and control tissues from these patients (n = 109) were assembled in a tissue microarray and evaluated for hormone receptors and markers of angiogenesis, cell-cycle progression and survival. Patient, tumor, and treatment variables were correlatively analyzed. RESULTS: The 5- and 10-year disease-specific survival (DSS) for the cohort was 42 and 27 %, respectively. Patients with primary intra-abdominal tumors had better outcomes than those with recurrent intraperitoneal tumors. Whites had a more favorable prognosis. In patients with intra-abdominal tumors, only mitotic count >10M/10HPF portended poorer prognosis. Patients with pulmonary metastasis had improved outcomes with "curative" metastasectomy. ULMS samples exhibited loss of ER and PR expression, overexpressed Ki-67, and altered p53, Rb, p16, cytoplasmic β-catenin, EGFR, PDGFR-α, PDGFR-β, and AXL levels. Metastatic tumors had increased VEGF, Ki-67, and survivin expression versus localized disease. Survivin and β-catenin expression were associated with intraperitoneal recurrence; high bcl-2 expression predicted longer DSS. CONCLUSIONS: Analysis of both clinicopathologic factors and immunohistochemical biomarkers in ULMS identified several prognostic clinical and molecular factors, suggesting that further study may lead to improved ULMS understanding and treatment. More... »

PAGES

2364-2372

Identifiers

URI

http://scigraph.springernature.com/pub.10.1245/s10434-012-2834-0

DOI

http://dx.doi.org/10.1245/s10434-012-2834-0

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1033723873

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/23334251


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