Analysis of the treatment efficacy in patients with uterine leiomyosarcoma
Summary. Objective: analysis of complex treatment results of patients with uterine leiomyosarcoma. There were analysed treatment results of 84 patients with uterine leiomyosarcoma stages I–IV (T1-3N0M1), who underwent treatment in SI «Grigoriev Institute for Medical Radiology, National Academy of Medical Sciences of Ukraine», from 1996 to 2018. All patients underwent surgery, radiotherapy and chemotherapy. The treatment efficacy was assessed by immediate results and long-term follow-up. The morbidity peak was observed in the age category of 40–49 years — 40.5% (34 patients). In 34 (40.5%) of 84 patients there was detected manifestation of the disease: in 5 patients (14.7%) — locoregional relapsed disease, in 29 (85.3%) patients — distant metastases. At the first stage of the disease, the relapse was detected in 3 (4.6%) patients, and metastasis — in 18 (27.7%) of 65 patients. In patients with stage II there was not established relapsed disease, but metastases were detected in 6 (50.0%) of 12 patients. In case of stage III disease, the recurrence was detected in 2 (66.7%) patients, and metastasis — in 1 (33.3%) of 3 patients with manifestation of the disease. In patients with stage IV the disease manifestation was noted in 4 (100.0%) patients due to the progression of distant metastases. Local disease progression was not detected in any of these patients. Tumor progression was detected in 58.8% of patients within the first year of treatment, and in 82.4% — during the first 2 years. In general, the 5-year non-progressive survival rate of patients was 59.5%, without taking into consideration the stage of disease. The relapse-rate in leiomyosarcoma patients was increased proportionally to stage of the disease. The median time to recurrence in patients with stages I–III is identical and makes up 10.0–11.0 months. Five-year disease-free survival of patients with uterine leiomyosarcoma, without taking into consideration the stage of disease and treatments method is 59.5%.
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