Leiomyosarcoma of the extremity deep soft tissues: analysis of factors predictive of survival and imaging features

Abstract

Objective:  This study aimed to report the visual outcomes of deeply located Leiomyosarcoma (LMS) in the extremities and treatment results.

Methods: The histological diagnosis of each case was confirmed by the pathology council and only cases with LMS localized in the deep soft tissue of the limb were included in this study. Treatment-related factors such as all the visual features of the tumor, type of therapy, local and distant recurrence, follow-up time, and outcome were analyzed. Overall survival time was determined.

Results: Evaluation was made of 17 patients, comprising 11 females and 6 males with a mean age of 64.35 years (range, 52-75 years). The localization of the primary lesion was the lower extremity in 14 patients (82.34%), and the upper extremity in 3 (17.34%). The average size of the lesions was 8.23 cm (range, 3-22 cm). All lesions were staged according to the TNM Classification of soft tissue sarcomas, as 3 (17.64%) patients in stage IIA, 9 (52.94%) in stage IIB, and 5 (29.41%) in stage IV. In the radiological features of the lesions, only two patients had scattered calcification and osseous pathology in the tumor tissue. The signal properties obtained in other soft tissue sarcomas on magnetic resonance images (MRI) were also present in these lesions. Neoadjuvant chemotherapy was applied to 5 of 17 patients, and surgical and adjuvant radiotherapy was applied to the remaining 12 patients. These patients were followed up for an average of 66 (23-111) months. Local recurrence occurred in 3 patients. The five-year disease-free survival rate was 58.8%, and the disease-survival rate was 64.7%.

Conclusion: The most important result of this study was that the only effective factor on overall survival is tumor size (p <0.001). Neoadjuvant chemotherapy was not seen to have any significant effect on this disease.