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uterine leiomyosarcoma

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https://www.readbyqxmd.com/read/28228279/loss-of-pten-is-associated-with-resistance-to-anti-pd-1-checkpoint-blockade-therapy-in-metastatic-uterine-leiomyosarcoma
#1
Suzanne George, Diana Miao, George D Demetri, Dennis Adeegbe, Scott J Rodig, Sachet Shukla, Mikel Lipschitz, Ali Amin-Mansour, Chandrajit P Raut, Scott L Carter, Peter Hammerman, Gordon J Freeman, Catherine J Wu, Patrick A Ott, Kwok-Kin Wong, Eliezer M Van Allen
Response to immune checkpoint blockade in mesenchymal tumors is poorly characterized, but immunogenomic dissection of these cancers could inform immunotherapy mediators. We identified a treatment-naive patient who has metastatic uterine leiomyosarcoma and has experienced complete tumor remission for >2 years on anti-PD-1 (pembrolizumab) monotherapy. We analyzed the primary tumor, the sole treatment-resistant metastasis, and germline tissue to explore mechanisms of immunotherapy sensitivity and resistance...
February 21, 2017: Immunity
https://www.readbyqxmd.com/read/28216458/incidence-of-malignancy-and-fibroid-variants-at-surgery-for-presumed-benign-symptomatic-fibroids
#2
Monique Ramos Damasco, Pui-Wan Kiri Chan, Marnie Slonim, Woun-Eng Catarina Ang, Martin Graham Healey
STUDY OBJECTIVE: In women undergoing hysterectomy or myomectomy for benign gynecology indications, where fibroids were present, to estimate the incidence of (1) leiomyosarcoma (LMS), (2) other uterine pathology (3) the frequency of use of morcellation, both mechanical and manual in laparoscopic, vaginal and laparotomy operative routes. DESIGN: Retrospective study (Canadian Task Force classification II-3). SETTING: The Royal Women's Hospital, Melbourne Australia...
February 16, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28209496/uterine-leiomyosarcoma-epidemiology-contemporary-treatment-strategies-and-the-impact-of-uterine-morcellation
#3
Stephanie Ricci, Rebecca L Stone, Amanda N Fader
Leiomyosarcoma, a rare tumor subtype, accounts for 1% of all uterine malignancies, but contributes to a significant proportion of uterine cancer deaths. Surgery is considered the mainstay of treatment for all soft tissue sarcomas, including uterine variants. However, uterine leiomyosarcoma is challenging to diagnose preoperatively and can mimic the appearance of benign uterine leiomyomas. Recently, concerns have grown in this regard, as surgeons have utilized uterine morcellation and myomectomy procedures unknowingly in the setting of occult uterine sarcoma...
February 13, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28191293/the-imaging-and-pathological-features-of-metastatic-leiomyosarcoma-in-the-gallbladder
#4
Yi Guo, Eleanor Chen, Darin J Davidson, Venu G Pillarisetty, Robin L Jones, Seth M Pollack
Uterine leiomyosarcoma is a rare and aggressive malignancy with poor overall prognosis. There have been few reports of metastatic leiomyosarcoma in the gallbladder. We report a case of a 41-year-old female who underwent total abdominal hysterectomy due to presumed uterine fibroids. The postoperative pathology revealed high-grade pleomorphic leiomyosarcoma, with involvement of the uterine serosal surface. She subsequently underwent exploratory laparotomy, followed by pelvic radiation and chemotherapy. Since initial management she has developed metastatic disease and has been under treatment and surveillance for 11 years...
November 17, 2016: Rare Tumors
https://www.readbyqxmd.com/read/28188392/current-status-of-uterine-leiomyosarcoma-in-the-tohoku-region-results-of-the-tohoku-translational-center-development-network-survey
#5
Hideki Tokunaga, Fumiaki Takahashi, Hiroki Yamamoto, Tsuyoshi Honda, Takafumi Watanabe, Tadahiro Shoji, Toru Sugiyama, Hidekazu Yamada, Tomoe Tando, Kosuke Yoshinaga, Satoko Kagabu, Takeo Otsuki, Shogo Kin, Yoshihito Yokoyama, Satoshige Wagatsuma, Kazuyo Sato, Hirokazu Sato, Takashi Oishi, Yuji Yoshida, Tadashi Hayasaka, Toshihiko Matsui, Noriaki Imai, Hidekazu Nishigori, Hiroaki Shimokawa, Nobuo Yaegashi, Yoh Watanabe
BACKGROUND: To prepare for a future clinical trial for improving the long-term prognosis of patients with uterine leiomyosarcoma (ULMS), we conducted a multi-institutional survey in the Tohoku region of Japan. METHODS: We conducted a retrospective cohort study between 2011 and 2014 in member institutions of the Tohoku Translational Research Center Development Network. RESULTS: A total of 53 patients with ULMS were registered in 31 institutions for the present survey...
February 10, 2017: International Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28181940/stable-disease-in-a-patient-with-metastatic-leiomyosarcoma-treated-with-trabectedin
#6
Ketty Tavella, Alessandro Villanucci, Laura Vannini, Daniele Lavacchi, Silvia Montelatici, Gianni Amunni, Teresita Mazzei
Leiomyosarcomas represent the most common variant of uterine sarcomas, and are also considered to be the least chemosensitive. To date, adriamycin and ifosfamide are believed to be the most effective drugs for its treatment, in addition to docetaxel and gemcitabine. Recently, the introduction of trabectedin has provided clinicians with another treatment option, and the drug may have some benefits for patients as it may allow for long-term treatment. We present the case of a patient who previously failed multiple cycles of chemotherapy and who was subsequently treated with 30 cycles of trabectedin as third-line therapy for multiple metastases of uterine leiomyosarcoma...
February 8, 2017: Anti-cancer Drugs
https://www.readbyqxmd.com/read/28174295/optimizing-local-control-in-high-grade-uterine-sarcoma-adjuvant-vaginal-vault-brachytherapy-as-part-of-a-multimodal-treatment
#7
Pierre Annede, Sébastien Gouy, Renaud Mazeron, Enrica Bentivegna, Pierre Maroun, Claire Petit, Isabelle Dumas, Alexandra Leary, Catherine Genestie, Catherine Lhommé, Eric Deutsch, Philippe Morice, Patricia Pautier, Christine Haie-Meder, Cyrus Chargari
PURPOSE: The phase III European Organization for Research and Treatment of Cancer 55874 study has shown that external beam radiotherapy (EBRT) given as adjuvant treatment decreased locoregional recurrences from 40% to 20% in patients (pts) with localized uterine sarcomas (US). No data exist, however, on the place of brachytherapy (BT). MATERIAL AND METHODS: We conducted a single-center retrospective analysis of pts receiving adjuvant BT of the vaginal vault based on the vaginal mold technique as part of their multimodal adjuvant treatment for a high-grade US from 1985 to 2015...
February 7, 2017: Oncologist
https://www.readbyqxmd.com/read/28170091/prevalence-of-occult-pre-malignant-or-malignant-pathology-at-the-time-of-uterine-morcellation-for-benign-disease
#8
Emily C Von Bargen, Cara L Grimes, Kavita Mishra, Rui Wang, Miriam J Haviland, Michele R Hacker, Joseph A Carnevale, Alyssa J Estes, Eman A Elkadry
OBJECTIVE: To determine the prevalence of occult pre-malignant or malignant uterine pathology at the time of laparoscopic surgery with open power morcellation for benign gynecologic disease. METHOD: The present multicenter, retrospective cohort study included women who underwent open power morcellation for benign indications between January 1, 2007, and February 28, 2014, at three academic medical centers in the USA. The primary outcome was pre-malignant or malignant pathology at the time of open power morcellation, and was determined from the patients' pathology reports...
February 7, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28130839/abnormal-p53-and-p16-staining-patterns-distinguish-uterine-leiomyosarcoma-from-inflammatory-myofibroblastic-tumour
#9
Inga-Marie Schaefer, Jason L Hornick, Lynette Marie Sholl, Bradley J Quade, Marisa R Nucci, Carlos Parra-Herran
AIMS: Uterine myxoid leiomyosarcoma may show relatively bland histologic appearances despite its aggressive behaviour. Distinguishing uterine leiomyosarcoma from the more indolent inflammatory myofibroblastic tumour (IMT), which is amenable to targeted therapies, can be challenging. A significant subset of leiomyosarcomas harbour TP53 and/or CDKN2A genomic alterations. Here, we examined the diagnostic value of p53 and p16 immunohistochemistry in the distinction of uterine conventional and myxoid leiomyosarcoma from IMT, in correlation with targeted sequencing of TP53 and CDKN2A...
January 28, 2017: Histopathology
https://www.readbyqxmd.com/read/28128524/uterine-leiomyosarcoma-a-review-of-recent-advances-in-molecular-biology-clinical-management-and-outcome
#10
REVIEW
Rosa R Cui, Jason D Wright, June Y Hou
Uterine leiomyosarcoma (LMS) are rare but aggressive tumors with poor clinical outcomes regardless of stage. Most tumors are identified by histopathology at time of surgery, and pre-operative diagnosis remains a clinical challenge. Management of early-stage LMS relies on surgical resection. Cytotoxic chemotherapy remains the mainstay of therapy for advanced-stage, recurrent, or metastatic LMS, and includes single or combination doxorubicin-, ifosfamide-, or gemcitabine-based regimens. Recent interest in genetic biomarkers led to developments of targeted therapies for LMS, although more research is needed to understand the molecular complexities underlying LMS to guide the development of novel treatment strategies...
January 27, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28120430/morcellating-uterine-mesenchymal-tumors-the-pathologist-s-view
#11
Kitty Pavlakis, Irini Messini, Petros Yiannou, Theofani Gavresea, Dimitris Chrysanthakis, Georgios Hilaris, Theodoros Panoskaltsis
AIM: The study was conducted to delineate the histological problems in diagnosing uterine mesenchymal tumors in morcellated material. METHODS: All cases of morcellated uteri performed between 2008 and 2014 were reviewed. The incidence of unexpected malignancy, defined as any neoplasm with a clear-cut diagnosis of leiomyosarcoma (LMS) or endometrial stromal sarcoma (ESS), was noted. Cases with absolute discrepancy between the diagnosis of the morcellated tumor and the subsequent diagnosis were also included in the study...
January 25, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28109626/significance-of-lymph-node-metastasis-on-survival-of-women-with-uterine-adenosarcoma
#12
Hiroko Machida, Michael J Nathenson, Tsuyoshi Takiuchi, Crystal L Adams, Jocelyn Garcia-Sayre, Koji Matsuo
OBJECTIVE: Uterine adenosarcoma (UAS) is a rare gynecologic malignancy and the significance of lymph node metastasis on survival has not been well studied. METHODS: A retrospective study was performed utilizing the Surveillance, Epidemiology, End Results Program to examine UAS (n=994), endometrial stromal sarcoma (ESS, n=2910), and uterine leiomyosarcoma (LMS, n=5506) diagnosed between 1973 and 2013. The impact of lymph node metastasis on cause-specific survival (CSS) was cross-compared by multivariable analysis...
January 18, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28094040/a-phase-2-study-of-alisertib-mln8237-in-recurrent-or-persistent-uterine-leiomyosarcoma-an-nrg-oncology-gynecologic-oncology-group-study-0231d
#13
David M Hyman, Michael W Sill, Heather A Lankes, Richard Piekarz, Mark S Shahin, Mildred R Ridgway, Floor Backes, Meaghen E Tenney, Cara A Mathews, James S Hoffman, Carol Aghajanian, Martee L Hensley
OBJECTIVE: This two-stage Phase II study assessed the activity of single agent alisertib in patients with recurrent/persistent uterine leiomyosarcoma (uLMS). METHODS: Eligibility criteria included histologically-confirmed, recurrent or persistent uLMS, age≥18, 1-2 prior cytotoxic regimens, and RECIST version 1.1 measurable disease. The primary objective of the study was to evaluate the efficacy of alisertib through the frequency of patients with objective tumor responses and the frequency who survived event-free for at least 6months (EFS6)...
January 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28093192/spectrum-of-mutations-in-leiomyosarcomas-identified-by-clinical-targeted-next-generation-sequencing
#14
Paul J Lee, Naomi S Yoo, Ian S Hagemann, John D Pfeifer, Catherine E Cottrell, Haley J Abel, Eric J Duncavage
Recurrent genomic mutations in uterine and non-uterine leiomyosarcomas have not been well established. Using a next generation sequencing (NGS) panel of common cancer-associated genes, 25 leiomyosarcomas arising from multiple sites were examined to explore genetic alterations, including single nucleotide variants (SNV), small insertions/deletions (indels), and copy number alterations (CNA). Sequencing showed 86 non-synonymous, coding region somatic variants within 151 gene targets in 21 cases, with a mean of 4...
January 14, 2017: Experimental and Molecular Pathology
https://www.readbyqxmd.com/read/28066666/ct-guided-percutaneous-microwave-ablation-of-pulmonary-malignant-tumors
#15
Wei-Chun Ko, Yee-Fan Lee, Yi-Chang Chen, Ning Chien, Yu-Sen Huang, Yao-Hui Tseng, Jang-Ming Lee, Hsao-Hsun Hsu, Jin-Shing Chen, Yeun-Chung Chang
BACKGROUND: Microwave ablation (MWA) of lung tumors is a new approach for local tumor control. The purpose of this retrospective study was to evaluate the preliminary results of safety and efficacy of MWA with a dynamic frequency range (902-928 MHz) and power (10-32 W) for local tumor control of thoracic malignancies. METHODS: From December 1, 2013 to February 1, 2016, there were total 32 lung tumors among 15 patients (7 men, 8 women, age range 43-82 years, mean 57...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28004108/potential-role-of-bcl2-in-the-recurrence-of-uterine-smooth-muscle-tumors-of-uncertain-malignant-potential
#16
Donatella Conconi, Valentina Chiappa, Patrizia Perego, Serena Redaelli, Giorgio Bovo, Marialuisa Lavitrano, Rodolfo Milani, Leda Dalprà, Andrea Alberto Lissoni
Uterine smooth muscle tumors are the most common female genital tract neoplasms. While leiomyosarcoma has been studied at length, smooth muscle tumors of uncertain malignant potential (STUMPs) still have ambiguous and unresolved issues, with a risk of relapse and evolution largely undefined. We performed an array comparative genomic hybridization analysis on a primitive STUMP and its local recurrence, histologically diagnosed as undifferentiated sarcoma. To the best of our knowledge, our report is the first genomic study on primitive STUMPs and the different relapsed tumors...
January 2017: Oncology Reports
https://www.readbyqxmd.com/read/28002210/european-society-of-gynecological-oncology-statement-on-fibroid-and-uterine-morcellation
#17
Michael J Halaska, Dimitrios Haidopoulos, Frédéric Guyon, Philippe Morice, Ignacio Zapardiel, Vesna Kesic
Recently, there has been an intense discussion about the issue of fibroid and uterine morcellation in relation to the risk of unrecognized uterine sarcoma spread. Morcellation can negatively influence the prognosis of patients, and transecting the specimen into pieces prevents the pathologist from performing proper disease staging. Many societies have published their statements regarding this issue. The European Society for Gynecological Oncology has established a working group of clinicians involved in diagnostics and treatment of oncogynecological patients to provide a statement from the oncological point of view...
January 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/27997438/diffusion-weighted-imaging-for-differentiating-uterine-leiomyosarcoma-from-degenerated-leiomyoma
#18
Hai Ming Li, Jia Liu, Jin Wei Qiang, Hao Zhang, Guo Fu Zhang, FengHua Ma
PURPOSE: The study aimed to investigate magnetic resonance diffusion-weighted imaging (DWI) in the differentiation of uterine leiomyosarcoma (ULMS) from degenerated leiomyoma (DLM). METHODS: Sixteen patients with ULMSs and 26 patients with DLMs confirmed by surgery and pathology underwent conventional magnetic resonance imaging and DWI. The mean apparent diffusion coefficient (ADC) values of the 2 groups' tumors were measured and compared using an independent-sample t test (b = 0...
December 15, 2016: Journal of Computer Assisted Tomography
https://www.readbyqxmd.com/read/27994831/primary-intraosseous-smooth-muscle-tumor-of-uncertain-malignant-potential-original-report-and-molecular-characterization
#19
Lauren Kropp, Gene P Siegal, Garrett M Frampton, Michael G Rodriguez, Svetlana McKee, Robert M Conry
We report the first case of primary intraosseous smooth muscle tumor of uncertain malignant potential (STUMP) which is analogous to borderline malignant uterine smooth muscle tumors so designated. The tumor presented in the femur of an otherwise healthy 30-year-old woman. Over a 3-year period, the patient underwent 11 biopsies or resections and 2 cytologic procedures. Multiple pathologists reviewed the histologic material including musculoskeletal pathologists but could not reach a definitive diagnosis. However, metastases eventually developed and were rapidly progressive and responsive to gemcitabine and docetaxel...
November 17, 2016: Rare Tumors
https://www.readbyqxmd.com/read/27974911/the-etiopathogenesis-of-uterine-fibromatosis
#20
EDITORIAL
L Manta, N Suciu, O Toader, R M Purcărea, A Constantin, F Popa
Uterine fibroids or uterine leiomyomas are the most common benign tumors of the uterus among women of fertile age, while the etiology is still incompletely elucidated. The occurrence and development of the fibromatosis may be related to certain risk factors and genic mechanisms, although the exact causes are not yet fully known. The development of uterine fibroids is correlated not only with the metabolism and with the level of female sexual hormones, estrogen, and progesterone, but also with the number of these hormone receptors expressed on the surface of the myometrium...
January 2016: Journal of Medicine and Life
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