Addition of postoperative chemotherapy to prevent or delay recurrence in patients newly diagnosed with localized uterine leiomyosarcoma and who have undergone complete tumor surgery.

Start Date27 Jan 2025

Sponsor / Collaborator

UNICANCER

[+4]

NCT05649956

/ RecruitingPhase 2IIT

A Randomized Phase II Study of Letrozole Versus Observation in Patients with Newly Diagnosed Uterine Leiomyosarcoma

This is a clinical trial to test letrozole in patients with uterine leiomyosarcoma. The main question is will treatment with letrozole extend progression-free survival in patients. Patients will receive 2/5 mg of letrozole daily.

Start Date17 Jul 2024

Sponsor / Collaborator

The Gynecologic Oncology Group

NCT06244251

/ Active, not recruitingNot ApplicableIIT

Comparison of Operational Outcomes and Long-term Benefits Between Laparoendoscopic Single-site Surgery and Multi-port Laparoscopy in Treating Uterine Fibroids

Myomectomy was preferably applied in females with reproductive requirements, which could be achieved by transumbilical laparoendoscopic single-site surgery (TU-LESS) or multi-port laparoscopic surgery (MPLS). Power morcellation used in MPLS was correlated with unidentified risk of tumor dissemination, especially in cases with accidental surgical findings of uterine sarcoma or leiomyosarcoma. Moreover, TU-LESS was reported to exceed MPLS in fast recovery. Therefore, the aim of this prospective cohort study is to compare the effectiveness of fast recovery and relative risk of tumor dissemination between TU-LESS and MPLS in myomectomy for the treatment of uterine fibroids.

Start Date24 Jun 2023

Sponsor / Collaborator

West China Second Hospital of Sichuan University

100 Clinical Results associated with Uterine Leiomyosarcoma

100 Translational Medicine associated with Uterine Leiomyosarcoma

0 Patents (Medical) associated with Uterine Leiomyosarcoma

1,417

Literatures (Medical) associated with Uterine Leiomyosarcoma

01 Jun 2025·European Journal of Radiology

Novel approach to MRI based risk stratification of uterine myometrial lesions

Article

Author: Dabi, Yohann ; Arbel, Safaa ; Thomassin-Naggara, Isabelle ; Haddad, Bassam ; Rouhban, Rana Al ; Florin, Marie ; Zlotykamien-Taieb, Eva ; Darai, Emile ; Jha, Priyanka ; Gherman, Diana

BACKGROUNDSurgery for uterine mesenchymal tumors is common in gynecology. Preoperative diagnosis of malignant tumors can lead to appropriate management for the lesions.PURPOSEThis study aims to externally validate a previous MRI-based expert consensus algorithm and evaluate the potential modification of MR-based scoring system's accuracy in diagnosing uterine mesenchymal tumors (UMT).MATERIAL AND METHODSWith institutional ethics committee approval and a waiver of informed consent (CRM-2405-410), a bicentric retrospective observational cohort study was conducted from January 2018 to December 2023. The study included women with a pathological diagnosis of uterine mesenchymal tumor following a pelvic MRI within six months. Clinical and MR criteria were blindly recorded by two radiologists (6- and 3-years' experience in gynaecological MR imaging) who assessed several MR features. Continuous variables were analyzed using a Mann-Whitney test, and categorical variables using Fisher's exact test. Odds ratios (OR) for predicting malignancy were calculated with 95% confidence intervals and p-values.RESULTSThe cohort included 455 women (mean age: 43 years, range: 15-82 years) with mesenchymal tumors: 437 leiomyomas, 2 STUMPs (0.4 %), and 16 malignant UMT (3.5 %). Using initial criteria (enlarged pelvic lymph nodes, T2W signal intensity, DW signal intensity compared to endometrium, and ADC cutoff value of 0.9 × 10^-3 mm²/sec), the model accurately classified 421 out of 455 cases (Accuracy: 92,5% (CI 93,1-94,3) and missed with 7 tumors (5 leiomyosarcomas, 2 STUMP). The sensitivity was 61.1 % (CI95% 38.5-83.6) and specificity was 93.8 % (CI95% 91.2-95.8) A modified algorithmic approach added "irregular tumor margins" and menopausal status, modified DW signal compared to bladder, and an elevated ADC cutoff value of 1.23 × 10^-3 mm²/sec, improving classification to 446 out of 455 cases (Accuracy: 98 % (CI95% 97.1 %-98.1 %) with only 3 missed tumors (2 STUMP and one leiomyosarcoma). The sensitivity was 83.3 % (CI95% 79-88) and specificity was 98.6 % (CI95% 98-99). The new algorithm significantly improved accuracy (p = 0.001), allowing the development of a 5-category scoring system.CONCLUSIONModified MR imaging evaluation algorithms increase true positive diagnosis of malignant UMTs leading to effective differentiation from benign leiomyomas. The new algorithm can allow for appropriate triage of potentially malignant UMTs, alleviating risk associated with morcellation in patients with uterine leiomyosarcoma.SUMMARYOur study demonstrates that combining 5 criteria based on multivariate analysis in a new algorithm (T2W signal, DW signal, ADC cut off value of 1.23 x 10-3 mm2/sec, tumor margins and menopausal status) allows us to distinguish benign from malignant uterine mesenchymal tumors with an accuracy of 98 % (CI95% 97,1%-98,1%), a sensitivity of 83.3 % (CI95% 79-88) and a specificity of 98.6 % (CI95% 98-99). This model allows to build a stratification score that would help in the management of typical and atypical uterine lesions.

01 May 2025·European Journal of Cancer

Conference on challenges in sarcoma (CCS) 2024: Expert opinions on non-evidence-based management aspects

Article

Author: Leva, Vidmane-Ozola ; Christian, Rothermundt ; Daphne, Hompes ; Ninna, Aggerholm Pedersen ; Minna, Laitinen ; Craig, Gerrand ; Cécile, Le Pechoux ; Robin, Jones ; Paolo, Spinnato ; Cleo, Romagosa ; Jakob, Jens ; Daniel, Mueller ; Liegl-Atzwanger, Bernadette ; Jendrik, Hardes ; Gunhild, Mechtersheimer ; Leithner, Andreas ; Akmel, Safwat ; Piotr, Rutkowski ; Kunz Wolfgang, G. ; Szkandera, Joanna ; Mahbubl, Ahmed ; Peter, Hohenberger ; Attila, Kollàr ; Beata, Bode ; Malee, Fernando ; Christina, Fotopoulou ; Michelle, Wilkinson ; Peter, Reichardt ; Eric, Staals ; Reichardt, Peter ; Aisha, Miah ; Miah, Aisha ; Katrin, Scheinemann ; Marinela, Augustin ; Rothermundt, Christian ; Jens, Jakob ; Schaarschmidt, Benedikt M. ; Fatime, Krasniqi ; Veronika, Blum ; Lars, Lindner ; Bonvalot, Sylvie ; Wardelmann, Eva ; Antonia, Digklia ; Ralph, Zachariah ; Elisabeth, Engelmann Bodil ; Hohenberger, Peter ; Haas, Rick L ; Kunz, Wolfgang G. ; Lorenz, Bankel ; Mateusz, Spalek ; Matthias, Grube ; Andreas, Leithner ; Jean-Yves, Blay ; Barbara, Kopf ; Eva, Wardelmann ; Judith, Bovee ; Andreou, Dimosthenis ; Hans, Gelderblom ; Hardes, Jendrik ; Palma, DiLeo ; Bode, Beata ; Frederic, Chibon ; Gerard, Van Oortmerssen ; Rick, Haas ; Silvia, Hofer ; Gelderblom, Hans ; Angelo, Dei Tos ; Joanna, Szkandera ; Scheinemann, Katrin ; Ingrid, Desar ; Thomas, Schubert ; Hanna, Koseła-Paterczyk ; Rutkowski, Piotr ; Benedikt, Schaarschmidt ; Bernadette, Liegl-Atzwanger ; Hofer, Silvia ; Sylvie, Bonvalot ; Winan, Van Houdt ; Emanuela, Palmerini ; Chantal, Pauli ; Lindner, Lars ; Bruno, Fuchs ; Anne, Floercken ; Pauli, Chantal ; Shane, Zaidi ; Thomas, Barth ; Fotopoulou, Christina ; Dimosthenis, Andreou

BACKGROUNDSoft tissue sarcomas (STS) and other mesenchymal tumours belong to rare, heterogeneous neoplasms with over 150 subtypes that pose significant challenges in diagnosis and clinical decision making. While guidelines address evidence-based diagnostic and therapeutic procedures, clinical situations and scenarios without evidence remain controversial in daily practice. The 2024 Conference on Challenges in Sarcoma (CCS2024) aimed to narrow these gaps with the support of an international and multidisciplinary panel of sarcoma experts.METHODSA Delphi process identified 200 controversial questions across eight prioritised clinical scenarios, including tenosynovial giant cell tumour, synovial sarcoma of the extremities, retroperitoneal sarcomas, angiosarcoma, phyllodes tumour, malignant peripheral nerve sheath tumour, uterine leiomyosarcoma, and atypical lipomatous tumour.RESULTSSixty-four experts discussed 141 controversies during the conference and reached strong consensus (> 90 %) on 24 and consensus (> 75 %) on 45 key diagnostic and therapeutic issues, while unresolved controversies emphasized the need for further research.CONCLUSIONSCCS2024 provides a framework for clinical decision making and underscores the importance of consensus-driven approaches in the treatment of rare and complex malignancies.

31 Mar 2025·Journal of Neurosurgery: Case Lessons

A neurosurgical approach to skull metastasis from uterine leiomyosarcoma: illustrative case

Article

Author: Quiñones-González, Alba M. ; Uehara-Gonzalez, José Antonio ; Agustin-Godinez, Eduardo ; Velazquez-Zamarripa, Ana I. ; Varela-Avalos, Eliany ; Carrillo-Uzeta, Arturo Alejandro ; Medina-Romero, José Raymundo ; Romero-García, Patricia Anaid

BACKGROUNDLeiomyosarcoma (LMS), a smooth muscle–derived tumor, is associated with a poor prognosis and a high potential for metastasis to local and distal sites. Skull metastases are exceptionally rare, with few cases documented in the literature. Diagnosing and treating these lesions is challenging due to their nonspecific clinical presentation and imaging similarities to other tumors.OBSERVATIONSThe authors report the case of a 46-year-old female with a 4-month history of a right parietal tumor, accompanied by headaches and left hemiparesis. MRI revealed a heterogeneous, intra- and extra-axial lesion with irregular margins in the right parietal region. Resection of the tumor was performed, and histopathological findings confirmed a diagnosis of metastatic LMS involving the bone and dura. Postoperative radiotherapy was administered, and the patient showed no evidence of recurrence 1 year after initial treatment. A review of the past 30 years of existing case reports of uterine LMS (uLMS) with cranial and intracranial metastases is also provided.LESSONSThis report highlights the diagnostic and therapeutic complexity of metastatic LMS to the skull. Adjuvant radiotherapy might prove advantageous in improving the prognosis of patients with uLMS, underscoring the significance of integrating clinical, radiological, histopathological, and immunohistochemical findings for accurate diagnosis and management.

https://thejns.org/doi/10.3171/CASE24769

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