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Does Lymphadenectomy Improve Survival in Uterine Leiomyosarcoma?
Tolga Tasci1, Alper Karalok, Salih Taskin
1*Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Turkey; and †Department of Gynecologic Oncology, Ankara University School of Medicine, Ankara, Turkey; and ‡Department of Pathology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Turkey.
Introduction:
The role of lymphadenectomy in the management of uterine leiomyosarcoma (LMS) is controversial. We aimed to identify whether lymph node dissection (LND) has any survival benefit in uterine LMS.
Methods:
Data of 95 patients with histologically proven uterine LMS from 2 tertiary centers (1993 through 2009) were retrospectively analyzed. Kaplan-Meier and Cox proportional hazards regression models were used for analyses.
Results:
Mean age was 51.5 years. Thirty-six (37.9%) underwent LND. The median lymph node count was 54. Eight (22.2%) patients had lymphatic metastasis. Median follow-up was 26 months. Sixty-two (65%) patients had recurrence and 48 (50.5%) died. Median disease-free survival (DFS) was 19 months for both group of patients who had or did not have LND, and median overall survival (OS) was 29 and 26 months, respectively (P = 0.4). Five-year DFS was 35.9% vs 26.8% (P = 0.4), and 5-year OS was 45.4% vs 43.8% (P = 0.22) for the groups. Multivariate analyses did not reveal a single independent prognostic factor in respect to DFS or OS.
Conclusion:
Higher rate of lymph node metastasis in patients with extrauterine disease indicated the importance of LND in LMS. However, the survival benefit of lymphadenectomy could not be shown.
