Preoperative Diagnosis and Outcomes of Leiomyosarcoma An 8-Year Experience at a Single Community-Based Gynecologic Oncology Practice

OBJECTIVE: To characterize the preoperative evaluation, treatment, and outcomes of patients diagnosed with uterine leiomyosarcoma in a single community-based gynecologic oncology practice serving a large geographical area. STUDY DESIGN: A retrospective chart review was performed of 21 patients diagnosed with leiomyosarcoma between October 2006 and July 2014. RESULTS: Only 29% (n=6) of the patients were diagnosed with leiomyosarcoma incidentally. The other 71% (n=15) had a high preoperative suspicion for leiomyosarcoma, including 5 who were diagnosed by dilation and curettage. A total of 48% (n=10) presented with stage I disease, of which 30% (n=3) were diagnosed with leiomyosarcoma incidentally. 76% (n=16) of patients were treated with chemotherapy, with all but 1 receiving gemcitabine and docetaxel as their primary regimen. Median time to recurrence was 14 months, with a total recurrence rate of 43% (n=9), and 56% (n=5) of the recurrences occurring in stage I patients. Median overall survival was 20.6 months. CONCLUSION: Leiomyosarcoma continues to be a deadly disease; however, our low rate of incidentally diagnosed leiomyosarcoma, for both total and stage I patients, helps shift the focus to developing innovative preoperative diagnostic approaches.