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Mandato VD, Torricelli F, Mastrofilippo V, Palicelli A, Costagliola L, Aguzzoli L. Primary Ovarian Leiomyosarcoma Is a Very Rare Entity: A Narrative Review of the Literature. Cancers (Basel) 2023; 15:cancers15112953. [PMID: 37296915 DOI: 10.3390/cancers15112953] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/18/2023] [Accepted: 05/19/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Primary ovarian leiomyosarcoma is a very rare malignancy characterized by unclear management and poor survival. We reviewed all the cases of primary ovarian leiomyosarcoma to identify prognostic factors and the best treatment. METHODS We collected and analyzed the articles published in the English literature regarding primary ovarian leiomyosarcoma from January 1951 to September 2022, using PubMed research. Clinical and pathological characteristics, different treatments and outcomes were analyzed. RESULTS 113 cases of primary ovarian leiomyosarcoma were included. Most patients received surgical resection, associated with lymphadenectomy in 12.5% of cases. About 40% of patients received chemotherapy. Follow-up information was available for 100/113 (88.5%) patients. Stage and mitotic count were confirmed to affect survival, and lymphadenectomy and chemotherapy were associated with a better survival rate. A total of 43.4% of patients relapsed, and their mean disease-free survival was 12.5 months. CONCLUSIONS Primary ovarian leiomyosarcomas are more common in women in their 50s (mean age 53 years). Most of them are at an early stage at presentation. Advanced stage and mitotic count showed a detrimental effect on survival. Surgical excision associated with lymphadenectomy and chemotherapy are associated with increased survival. An international registry could help collect clear and reliable data to standardize the diagnosis and treatment.
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Affiliation(s)
- Vincenzo Dario Mandato
- Unit of Obstetrics and Oncological Gynecology, Azienda USL-IRCCS di, 42122 Reggio Emilia, Italy
| | - Federica Torricelli
- Laboratory of Translational Research, Azienda USL-IRCCS di, 42122 Reggio Emilia, Italy
| | - Valentina Mastrofilippo
- Unit of Obstetrics and Oncological Gynecology, Azienda USL-IRCCS di, 42122 Reggio Emilia, Italy
| | - Andrea Palicelli
- Unit of Pathology, Azienda USL-IRCCS di, 42122 Reggio Emilia, Italy
| | - Luigi Costagliola
- Unit of Obstetrics and Gynecology, Santa Maria delle Grazie Hospital, 80100 Naples, Italy
| | - Lorenzo Aguzzoli
- Unit of Obstetrics and Oncological Gynecology, Azienda USL-IRCCS di, 42122 Reggio Emilia, Italy
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Bahadur A, Mundhra R, Verma P, Phulware RH. Primary ovarian leiomyosarcoma in a woman with uterovaginal prolapse. BMJ Case Rep 2022; 15:e251733. [PMID: 36162964 PMCID: PMC9516082 DOI: 10.1136/bcr-2022-251733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Primary ovarian leiomyosarcoma is a very uncommon and aggressive neoplasm. We presented a right-sided ovarian leiomyosarcoma in a woman in her late 40s. No case has been described in the literature till now of primary ovarian leiomyosarcoma in a woman with uterovaginal prolapse. A total abdominal hysterectomy with bilateral adnexectomy, metastasectomy, excision of large tumour deposit over small intestine followed by resection with ileo-ileal anastomosis and omentectomy was performed. The diagnosis was made based on morphology along with immunohistochemistry. The patient was given adjuvant chemotherapy during postoperative period. Due to rarity, there is a dearth of information on the clinical behaviour and best treatment options for these tumours. This case report highlighted the importance of clinical awareness and aimed to provide a baseline to guide clinical practice as well as future research.
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Affiliation(s)
- Anupama Bahadur
- Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Rajlaxmi Mundhra
- Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Pallavi Verma
- Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ravi Hari Phulware
- Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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3
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Astore C, Zhou H, Ilkowski B, Forness J, Skolnick J. LeMeDISCO is a computational method for large-scale prediction & molecular interpretation of disease comorbidity. Commun Biol 2022; 5:870. [PMID: 36008469 PMCID: PMC9411158 DOI: 10.1038/s42003-022-03816-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 08/08/2022] [Indexed: 11/09/2022] Open
Abstract
To understand the origin of disease comorbidity and to identify the essential proteins and pathways underlying comorbid diseases, we developed LeMeDISCO (Large-Scale Molecular Interpretation of Disease Comorbidity), an algorithm that predicts disease comorbidities from shared mode of action proteins predicted by the artificial intelligence-based MEDICASCY algorithm. LeMeDISCO was applied to predict the occurrence of comorbid diseases for 3608 distinct diseases. Benchmarking shows that LeMeDISCO has much better comorbidity recall than the two molecular methods XD-score (44.5% vs. 6.4%) and the SAB score (68.6% vs. 8.0%). Its performance is somewhat comparable to the phenotype method-based Symptom Similarity Score, 63.7% vs. 100%, but LeMeDISCO works for far more cases and its large comorbidity recall is attributed to shared proteins that can help provide an understanding of the molecular mechanism(s) underlying disease comorbidity. The LeMeDISCO web server is available for academic users at: http://sites.gatech.edu/cssb/LeMeDISCO .
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Affiliation(s)
- Courtney Astore
- Center for the Study of Systems Biology, School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, 30332, USA
| | - Hongyi Zhou
- Center for the Study of Systems Biology, School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, 30332, USA
| | - Bartosz Ilkowski
- Center for the Study of Systems Biology, School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, 30332, USA
| | - Jessica Forness
- Center for the Study of Systems Biology, School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, 30332, USA
| | - Jeffrey Skolnick
- Center for the Study of Systems Biology, School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, 30332, USA.
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Cojocaru E, Palahepitiva Gamage G, Butler J, Barton DP, Thway K, Fisher C, Messiou C, Miah AB, Zaidi S, Gennatas S, Benson C, Huang P, Jones RL. Clinical management and outcomes of primary ovarian leiomyosarcoma - Experience from a sarcoma specialist unit. Gynecol Oncol Rep 2021; 36:100737. [PMID: 33732852 PMCID: PMC7941038 DOI: 10.1016/j.gore.2021.100737] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 02/07/2021] [Accepted: 02/15/2021] [Indexed: 12/23/2022] Open
Abstract
Ovarian sarcomas account for 1% of all ovarian malignancies and amongst these, primary ovarian leiomyosarcoma is the rarest subtype. Primary ovarian leiomyosarcoma has a very poor prognosis, with less than 20% of patients being alive at 5 years. Only a few cases have been published in the literature and there is very limited knowledge on the clinical behaviour and optimal management of these tumours. We have performed a retrospective analysis of a prospectively maintained database to identify all primary ovarian leiomyosarcoma diagnosed and treated at the Royal Marsden NHS Foundation Trust between 1998 and 2020. Sixteen patients were identified from our database and fifteen were eligible for the analysis. Twelve patients presented with localized disease and underwent initial surgery and three patients had metastatic disease at presentation. Recurrence-free survival post-surgery was 16 months. Eight patients received first-line chemotherapy and four patients received second-line chemotherapy. Two patients had indolent metastatic disease and benefited from local therapies only. The median overall survival in the metastatic setting in our cohort was 51 months, which is consistent with previously published cases. Primary ovarian leiomyosarcoma is an extremely rare malignancy with a poor prognosis. This study is the largest case series of primary ovarian leiomyosarcoma published to date, providing clinically important information regarding survival and metastatic rate as well as treatment outcomes in the metastatic setting.
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Affiliation(s)
- Elena Cojocaru
- Sarcoma Unit, The Royal Marsden Hospital, 203 Fulham Rd, London SW3 6JJ, UK
| | | | - John Butler
- Gynaecological Unit, The Royal Marsden Hospital, 203 Fulham Rd, London SW3 6JJ, UK
| | - Desmond P Barton
- St George's Hospital, Blackshaw Road, London, Greater London SW17 0QT, UK
| | - Khin Thway
- Sarcoma Unit, The Royal Marsden Hospital, 203 Fulham Rd, London SW3 6JJ, UK
| | - Cyril Fisher
- Department of Musculoskeletal Pathology, University Hospitals Birmingham, Birmingham B15 2GW, UK
| | - Christina Messiou
- The Institute of Cancer Research, Chester Beatty Laboratories, 237 Fulham Road, London SW3 6JB, UK.,Radiology Department, The Royal Marsden Hospital, 203 Fulham Rd, London SW3 6JJ, UK
| | - Aisha B Miah
- Sarcoma Unit, The Royal Marsden Hospital, 203 Fulham Rd, London SW3 6JJ, UK
| | - Shane Zaidi
- Sarcoma Unit, The Royal Marsden Hospital, 203 Fulham Rd, London SW3 6JJ, UK
| | - Spyridon Gennatas
- Sarcoma Unit, The Royal Marsden Hospital, 203 Fulham Rd, London SW3 6JJ, UK
| | - Charlotte Benson
- Sarcoma Unit, The Royal Marsden Hospital, 203 Fulham Rd, London SW3 6JJ, UK
| | - Paul Huang
- The Institute of Cancer Research, Chester Beatty Laboratories, 237 Fulham Road, London SW3 6JB, UK
| | - Robin L Jones
- Sarcoma Unit, The Royal Marsden Hospital, 203 Fulham Rd, London SW3 6JJ, UK.,The Institute of Cancer Research, Chester Beatty Laboratories, 237 Fulham Road, London SW3 6JB, UK
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Yuksel D, Cakir C, Kilic C, Karalok A, Kimyon G, Çöteli S, Boyraz G, Tekin ÖM, Turan T. Primary leiomyosarcoma of the ovary: a report of three cases and a systematic review of literature. J Gynecol Obstet Hum Reprod 2020; 50:101825. [PMID: 32497729 DOI: 10.1016/j.jogoh.2020.101825] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 05/25/2020] [Accepted: 05/27/2020] [Indexed: 11/26/2022]
Abstract
Primary ovarian leiomyosarcomas (POLMs) comprise <0.1 % of all ovarian malignancies. Here we aimed to define the clinical, surgical, and pathological features, as well as the oncologic outcome, of POLM. A systematic review of the medical literature was performed to identify articles about POLMs. An electronic literature search was conducted for English language abstracts of articles published between 1975 and December 2018.51 articles were included in the study. The primary endpoint of the study was disease-free survival (DFS) and overall survival (OS), whereas the secondary endpoint was clinicopathological features. Five-year DFS and OS for the entire cohort was 15 % and 26 %, respectively. The DFS and OS were significantly related to paraaortic lymphadenectomy, a mitotic index>10/high power field, and advanced cancer stages. Eventually, we were unable to obtain clear results, this might be due to the limited number of cases at the literature.With more authors presenting their own cases, it will be possible to have clearer results.
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Affiliation(s)
- Dilek Yuksel
- Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Clinic, Health Sciences University, Turkey.
| | - Caner Cakir
- Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Clinic, Health Sciences University, Turkey.
| | - Cigdem Kilic
- Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Clinic, Health Sciences University, Turkey.
| | - Alper Karalok
- Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Clinic, Health Sciences University, Turkey.
| | - Günsu Kimyon
- Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Clinic, Health Sciences University, Turkey.
| | - Sinem Çöteli
- Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Clinic, Health Sciences University, Turkey.
| | - Gokhan Boyraz
- Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Clinic, Health Sciences University, Turkey.
| | - Özlem Moraloğlu Tekin
- Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Department of Gynecology and Obstetrics, Health Sciences University, Turkey.
| | - Taner Turan
- Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Clinic, Health Sciences University, Turkey.
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