Tumor Genomics, Metastatic Patterns, and Prognosis in Leiomyosarcoma: A Single-Center Retrospective Cohort Study
Hayes Pearce1, Yu-Cherng Chang2, Sarah Wishnek Metalonis3
1Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
Cancers
|November 13, 2025
Summary
Leiomyosarcoma (LMS) patients with ATRX mutations or pleural metastases face poorer survival. Metastatic patterns differ between uterine and non-uterine LMS, impacting prognosis.
Area of Science:
- Oncology
- Genetics
- Pathology
Background:
- Leiomyosarcoma (LMS) is a rare soft tissue sarcoma with poorly understood prognostic factors.
- Tumor genomics and metastatic patterns are critical but incompletely defined in LMS prognosis.
Purpose of the Study:
- To investigate the association between tumor mutations, sites of metastasis, and survival outcomes in patients with LMS.
- To identify specific genomic alterations and metastatic patterns that predict prognosis in LMS.
Main Methods:
- Retrospective cohort study of 110 LMS patients with genomic testing.
- Analysis of tumor mutations, metastatic sites, and survival (Overall Survival, Progression-Free Survival/Recurrence-Free Survival).
- Kaplan-Meier and Cox proportional hazards regression models were used for survival analysis.
Main Results:
- TP53 and RB1 were the most common mutations; lungs and liver were the most frequent metastatic sites.
- ATRX mutations and pleural metastases were independently associated with lower Overall Survival (OS).
- Distinct metastatic patterns were observed between uterine and non-uterine LMS.
Conclusions:
- ATRX mutations and pleural metastases are adverse prognostic indicators in LMS.
- Metastatic patterns differ significantly between uterine and non-uterine LMS.
- Genomic alterations and metastatic sites have interdependent associations with LMS patient outcomes.
