Leiomyosarcoma: Prognostic Factors and Life Expectancy in Soft Tissue Sarcomas

The leiomyosarcoma is a type of soft tissue sarcoma that originates in smooth muscle and is known for its aggressive behavior and generally unfavorable prognosis. This type of tumor can occur in various locations, with the uterus and retroperitoneum being the most common. The complexity of its management and variability in treatment response make the prognosis of leiomyosarcoma a topic of great interest and relevance in current oncology, particularly regarding leiomyosarcoma survival rates.

Diving Deeper into Prognosis and Life Expectancy

The prognosis of leiomyosarcoma depends on multiple factors, including tumor size, location, histological grade, and the presence of metastases at the time of diagnosis. Recent studies have shown that the combination of doxorubicin with trabectedin improves overall survival and progression-free survival in patients with advanced or unresectable leiomyosarcoma compared to doxorubicin alone [1].

Additionally, a genomic risk stratification model has been developed to more accurately predict clinical outcomes in patients with leiomyosarcoma, which could guide more personalized therapeutic decisions [2]. This model is based on specific genomic alterations, such as mutations in RB1 and ATRX, which have been associated with a worse prognosis.

The five-year survival rate for patients with uterine leiomyosarcoma varies significantly, with rates ranging from 25% to 76%, depending on the stage at which the disease is diagnosed and the response to treatment [3]. The evaluation of peritoneal cytology during hysterectomy has also been identified as an important prognostic factor, complementing the FIGO classification [4].

Conclusions

The management of leiomyosarcoma remains a challenge due to its aggressive nature and variability in treatment response. However, advances in understanding prognostic factors, such as genomic alterations and new therapeutic combinations, offer renewed hope for improving survival rates in patients. Integrating these findings into clinical practice could allow for a more personalized and effective approach to treating this complex type of sarcoma.

Referencias

• [1] Doxorubicin alone versus doxorubicin with trabectedin followed by trabectedin alone as first-line therapy for metastatic or unresectable leiomyosarcoma (LMS-04): a randomised, multicentre, open-label phase 3 trial.
• [2] Developing Novel Genomic Risk Stratification Models in Soft Tissue and Uterine Leiomyosarcoma.
• [3] Comprehensive Review of Uterine Leiomyosarcoma: Pathogenesis, Diagnosis, Prognosis, and Targeted Therapy.
• [4] Correlation between malignant peritoneal cytology and survival in patients with uterine leiomyosarcoma and endometrial stromal sarcoma.

Created 14/1/2025