April 4th, 2020

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Preoperative Diagnosis and Outcomes of Leiomyosarcoma: An 8-Year Experience at a Single Community-Based Gynecologic Oncology Practice
Authors:  Olga T. Filippova, M.D., Heidi E. Godoy, D.O., Timothy J. McElrath, M.D., Daniel C. Kredentser, M.D., Patrick F. Timmins, III, M.D., and Joyce N. Barlin, M.D.
  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.
Keywords:  dilation and curettage, hysterectomy, leiomyosarcoma, morcellation, uterine neoplasms
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