Clinical case of long-term treatment of patient with uterine high-grade leiomyosarcoma
https://doi.org/10.33667/2078-5631-2020-38-25-28
Abstract
Uterine leiomyosarcoma refers to malignant tumors with an aggressive course, poor prognosis, and unsatisfactory long-term treatment results. The five-year overall survival rate ranges from 52–85% for the first stage of the disease to 10–29% for the fourth stage. The treatment method that determines the prognosis of both localized and disseminated leiomyosarcomas is currently radical surgery. In the case of unresectable leiomyosarcomas, drug therapy is performed. The problem of choosing the optimal treatment method for each patient with leiomyosarcoma is still relevant. We present a case of long-term treatment of a patient with high-grade uterine leiomyosarcoma from our own clinical practice. During treatment, the patient underwent 4 surgical interventions and 9 lines of drug therapy. At the moment, the patient is in the process of 10 lines of treatment. Duration of life from the moment of diagnosis is 108 plus months, and from the moment of dissemination of the disease is 97 plus months. This clinical case shows that timely performance of radical surgical interventions and rational choice of drug therapy regimens can significantly increase the average survival rate.
About the Authors
O. A. Rozonova
National Medical Research Centre of Oncology n.a. N.N. Blokhin
Russian Federation
Moscow
Russian Federation
Moscow
E. V. Artamonova
National Medical Research Centre of Oncology n.a. N.N. Blokhin; Russian National Research Medical University n.a. N.I. Pirogov
Russian Federation
Moscow
Russian Federation
Moscow
N. A. Kozlov
National Medical Research Centre of Oncology n.a. N.N. Blokhin
Russian Federation
Moscow
Russian Federation
Moscow
References
1. D’angelo E., Prat J. Uterine sarcomas: a review. Gynecol Oncol. 2010, v. 116, p. 131–139.
2. Skorstad M., Kent A., Lieng M. Uterine leiomyosarcoma – incidence, treatment, and the impact of morcellation. A nationwide cohort study. Acta Obstet Gynecol Scand 2016; 95: 984–90.
3. Jemal A., Siegel R., Xu J., Ward E. Cancer statistics 2010. CA Cancer J Clin 2010; 60: 277–300.
4. Major F.J., Blessing J.A., Silverberg S.G., Morrow C.P., Creasman W.T., Currie J.L., Yordan E., Brady M.F. Prognostic factors in early-stage uterine sarcoma. A Gynecologic Oncology Group study. Cancer. 1993 Feb 15; 71 (4 Suppl): 1702–9.
5. Kim H.J., Kim Y., Lee S.J., Lee J., Park S.H. Pazopanib monotherapy in the treatment of pretreated, metastatic uterine sarcoma: a single-center retrosrective study. J Gynecol Oncol. 2018, 29 (1): e3.
6. Kapp D.S., Shin J.Y., Chan J.K. Prognostic factors and survival in 1396 patients with uterine leiomyosarcomas: emphasis on impact of lymphadenectomy and oophorectomy, Cancer 112 (2008) 820–830.
7. Cybulska P., Sioulas V., Orfanelli T., Zivanovic O., Mueller J.J., Broach V.A., Long Roche K.C., Sonoda Y., Hensley M.L., O’Cearbhaill R.E., Chi D.S., Alektiar K.M., Abu-Rustum N.R., Leitao M. M. Secondary surgical resection for patients with recurrent uterine leiomyosarcoma. Gynecol Oncol. 2019 Aug; 154 (2): 333–337.
8. Sutton G., Blessing J.A., Malfetano J.H. Ifosfamide and doxorubicin in the treatment of advanced leiomyosarcomas of the uterus: a Gynecologic Oncology Group study, Gynecol. Oncol. 62 (1996) 226–229.
9. Omura G.A., Major F.J., Blessing J.A., et al., A randomized study of adriamycin with and without dimethyl triazenoimidazole carboxamide in advanced uterine sarcomas, Cancer 52 (1983) 626–632.
10. Piver M.S., Lele S.B., Marchetti D.L., et al., Effect of adjuvant chemotherapy on time to recurrence and survival of stage I uterine sarcomas, J. Surg. Oncol. 38 (1988) 233–239.
11. Giuntoli 2nd R.L., Metzinger D.S., DiMarco C.S., et al., Retrospective review of 208 patients with leiomyosarcoma of the uterus: prognostic indicators, surgical management, and adjuvant therapy, Gynecol. Oncol. 89 (2003) 460–469.
12. Hensley M. L., Blessing J. A., DeGeest K., Abulafia O., Rose P. G., Homesley H. D. Fixed dose rate gemcitabine plus docetaxel as second-line therapy for metastatic uterine leiomyosarcoma: a gynecologic oncology group phase II study, Gynecol. Oncol. 109 (2008) 323–328.
13. Garcia G, Kedia S, Dhar M. Long-term Survival in a Patient with Recurrent Pulmonary Metastases from Uterine Leiomyosarcoma. Cure us. 2015 Dec 15; 7 (12): e405.
14. Rajpurohit V., Mehta P., Kothari N., Nathani S. Leiomyosarcoma of the Right Ovarian Vein: a Case Report with Multimodality Management and Long-Term Follow-Up. Indian J Surg Oncol. 2019 Sep; 10 (3): 523–526.
Review
For citations:
Rozonova O.A., Artamonova E.V., Kozlov N.A. Clinical case of long-term treatment of patient with uterine high-grade leiomyosarcoma. Medical alphabet. 2020;(38):25-28. (In Russ.) https://doi.org/10.33667/2078-5631-2020-38-25-28
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