Gastrointestinal Stromal Tumors and Leiomyosarcoma of the Abdomen and Retroperitoneum: A Clinical Comparison
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Introduction: The present study was undertaken to define the clinical differences between leiomyosarcomas (LMS) occurring within the abdomen and retroperitoneum and gastrointestinal stromal tumors (GIST).
Methods: It was a retrospective, single-institution review of patients treated for intra-abdominal and retroperitoneal GIST and LMS from July 1, 1982 through August 1, 1999.
Results: A total of 561 patients, 239 with GIST and 322 with LMS, were identified. Patients with GIST were older, with a median age of 58 years versus 54 years in the LMS group (P < .01). The majority of patients with GIST were male (58%), whereas 68% of LMS patients (excluding gender-specific sites) were female (P < .01). The 5-year disease-specific survival for GIST and LMS were 28% and 29%, respectively. The presentation status and ability to achieve a complete surgical resection were the main independent predictors of outcome for both GIST and LMS. Local and distant recurrence was common in both. The pattern of distant recurrence differed: 50% of all first-site GIST recurrences involved the liver, whereas 30% of all LMS first-site recurrences involved the lungs.
Conclusions: Although the two patient populations appear to be distinct, their clinical courses are similar. The pattern of distant spread follows the known patterns of hematogenous dissemination. Complete surgical resection is the cornerstone of treatment for primary GIST and LMS and in selected patients with local and distant recurrence.
- Erlandson R, Klimstra D, Woodruff J. Subclassification of gastrointestinal stromal tumors based on evaluation by electron microscopy and immunohistochemistry. Ultrastruct Pathol 1996; 20: 373–93.
- Herrara G, Cerezo L, Jones J, Sack J, Grizzle W, Pollack W, Lott R. Gastrointestinal autonomic nerve tumors: “Plexosarcomas.” Arch Path Lab Med 1989; 113: 846–53.
- Herrera G, Demoraes H, Grizzle W, Han S. Malignant small bowel neoplasm of enteric plexus derivation (plexosarcoma): light and electron microscopic study confirming the origin of the neoplasm. Dig Dis Sci 1984; 29: 275–84.
- Starr G, Dockerty M. Leiomyomas and leiomyosarcomas of the small intestine. Cancer 1955; 8: 101–11.
- Kindblom L, Remotti H, Aldenborg F, Meis-Kindblom J. Gastrointestinal pacemaker cell tumor (GIPACT): gastrointestinal stromal tumors show phenotypic characteristics of the interstitial cells of Cajal. Am J Pathol 1998; 152: 1259–69.
- DeMatteo R, Lewis J, Leung D, Mudan SS, Woodruff J, Brennan M. Two hundred gastrointestinal stromal tumors: recurrence patterns and prognostic factors for survival. Ann Surg 2000; 231: 51–8. CrossRef
- Sondak V, Economou J, Eilber F. Soft tissue sarcomas of the extremity and retroperitoneum: advances in management. Adv Surg 1991; 24P: 333–59.
- Van Dam P, Lowe D, McKenzie-Gray B, Shepherd J. Retroperitoneal soft tissue sarcomas. Obstet Gynecol Surv 1990; 45: 670–82.
- Rajani B, Smith T, Reith J, Goldblum J. Retroperitoneal leiomyosarcomas unassociated with the gastrointestinal tract: a clinicopathologic analysis of 17 cases. Mod Pathol 1999; 12: 21–8.
- NgE, Pollock R, Romsdahl M. Prognostic implications of patterns of failure for gastrointestinal leiomyosarcomas. Cancer 1992; 69: 1334–41.
- Lee Y. Leiomyosarcoma of the gastro-intestinal tract: general pattern of metastasis and recurrence. Cancer Treat Rev 1983; 10: 91–101.
- Lewis J, Leung D, Woodruff J, Brennan M. Retroperitoneal soft-tissue sarcoma: analysis of 500 patients treated and followed at a single institution. Ann Surg 1998; 228: 355–65. CrossRef
- Todd C, Michael H, Sutton G. Retroperitoneal leiomyosarcoma: eight cases and a literature review. Gynecol Oncol 1995; 59: 333–7.
- Shmookler B, Lauer D. Retroperitoneal leiomyosarcoma: a clinicopathologic analysis of 36 cases. Am J Surg Pathol 1983; 7: 269–80.
- Kay S, McNeill D. Leiomyosarcoma of the retroperitoneum. Surg Gynecol Obstet 1969; 129: 285–8.
- de Waele B, van Belle S, Claes H, Goovaerts G, Delvaux G, Willems G. Retroperitoneal leiomyosarcoma. Acta Chir Belg 1987; 87: 229–34.
- Gadducci A, Landoni F, Sartori E, et al. Uterine leiomyosarcoma: analysis of treatment failures and survival. Gynecol Oncol 1996; 62: 25–32.
- NgE, Pollock R, Munsell M, Atkinson E, Romsdahl M. Prognostic factors influencing survival in gastrointestinal leiomyosarcomas. Implications for surgical management and staging. Ann Surg 1992; 215: 68–77. CrossRef
- Skandalakis J, Gray S. Smooth muscle tumors of the alimentary tract. In: Ariel I, ed. Progress in Clinical Cancer. New York: Grune & Stratton, 1965: 692–708.
- Gastrointestinal Stromal Tumors and Leiomyosarcoma of the Abdomen and Retroperitoneum: A Clinical Comparison
Annals of Surgical Oncology
Volume 8, Issue 4 , pp 290-299
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- Gastrointestincal stromal tumor
- Leiomyosarcoma—Retroperitoneal Sarcoma
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- Author Affiliations
- 1. Department of Surgery (BMC, RPD, JJL, MFB), Memorial Sloan-Kettering Cancer Center, New York, New York
- 2. Departments of Biostatistics (DL), Memorial Sloan-Kettering Cancer Center, New York, New York
- 3. Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY, 10021