Diagnostic criteria for uterine smooth muscle tumors: Leiomyoma variants associated with malignant behavior

Robert L. Giuntoli, Bobbie S. Gostout, Connie S. DiMarco, Daniel S. Metzinger, Gary Keeney

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

OBJECTIVE: To determine the prognostic accuracy of current diagnostic criteria for uterine smooth muscle tumors. STUDY DESIGN: Cases of uterine leiomyosarcoma (LMS) treated from 1976 to 1999 were analyzed retrospectively. Uterine LMS specimens were reevaluated using current criteria by a pathologist specializing in gynecologic diseases. Kaplan-Meier survival curves were evaluated. RESULTS: Specimens were available from 67 patients diagnosed with uterine LMS. On rereview, only 47 specimens were thought to represent uterine LMS. The 20 other patients were deemed to have leiomyomas or leiomyoma variants, including 13 cellular leiomyomas, 5 atypical leiomyomas and 2 leiomyomas. Median survival for patients with uterine LMS was 2.1 years. (Ninety-seven percent of disease-specific deaths occurred within 6 years after the diagnosis.) With leiomyoma variants, median survival was >25 years. Among these 18 women were 3 disease-specific deaths (all > 6 years after diagnosis). CONCLUSION: Diagnostic criteria for uterine smooth muscle tumors require continued refinement. A small but significant number of patients diagnosed with leiomyoma variants will die of the disease. In contrast to the aggressive behavior of uterine LMS, disease-specific deaths attributed to leiomy oma variants occurred later. With this potential for delayed recurrence, these patients warrant close clinical surveillance.

Original languageEnglish (US)
Pages (from-to)1001-1010
Number of pages10
JournalJournal of Reproductive Medicine for the Obstetrician and Gynecologist
Volume52
Issue number11
StatePublished - Nov 2007

Fingerprint

Smooth Muscle Tumor
Myometrium
Leiomyoma
Leiomyosarcoma
Uterine Diseases
Female Genital Diseases
Survival
Kaplan-Meier Estimate
Recurrence

Keywords

  • Leiomyoma
  • Leiomyoma variants
  • Leiomyosarcoma
  • Smooth muscle tumor
  • Uterine neoplasms

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Reproductive Medicine

Cite this

Diagnostic criteria for uterine smooth muscle tumors : Leiomyoma variants associated with malignant behavior. / Giuntoli, Robert L.; Gostout, Bobbie S.; DiMarco, Connie S.; Metzinger, Daniel S.; Keeney, Gary.

In: Journal of Reproductive Medicine for the Obstetrician and Gynecologist, Vol. 52, No. 11, 11.2007, p. 1001-1010.

Research output: Contribution to journalArticle

Giuntoli, Robert L. ; Gostout, Bobbie S. ; DiMarco, Connie S. ; Metzinger, Daniel S. ; Keeney, Gary. / Diagnostic criteria for uterine smooth muscle tumors : Leiomyoma variants associated with malignant behavior. In: Journal of Reproductive Medicine for the Obstetrician and Gynecologist. 2007 ; Vol. 52, No. 11. pp. 1001-1010.
@article{03567f987f6947cc894f8f81b358b6b2,
title = "Diagnostic criteria for uterine smooth muscle tumors: Leiomyoma variants associated with malignant behavior",
abstract = "OBJECTIVE: To determine the prognostic accuracy of current diagnostic criteria for uterine smooth muscle tumors. STUDY DESIGN: Cases of uterine leiomyosarcoma (LMS) treated from 1976 to 1999 were analyzed retrospectively. Uterine LMS specimens were reevaluated using current criteria by a pathologist specializing in gynecologic diseases. Kaplan-Meier survival curves were evaluated. RESULTS: Specimens were available from 67 patients diagnosed with uterine LMS. On rereview, only 47 specimens were thought to represent uterine LMS. The 20 other patients were deemed to have leiomyomas or leiomyoma variants, including 13 cellular leiomyomas, 5 atypical leiomyomas and 2 leiomyomas. Median survival for patients with uterine LMS was 2.1 years. (Ninety-seven percent of disease-specific deaths occurred within 6 years after the diagnosis.) With leiomyoma variants, median survival was >25 years. Among these 18 women were 3 disease-specific deaths (all > 6 years after diagnosis). CONCLUSION: Diagnostic criteria for uterine smooth muscle tumors require continued refinement. A small but significant number of patients diagnosed with leiomyoma variants will die of the disease. In contrast to the aggressive behavior of uterine LMS, disease-specific deaths attributed to leiomy oma variants occurred later. With this potential for delayed recurrence, these patients warrant close clinical surveillance.",
keywords = "Leiomyoma, Leiomyoma variants, Leiomyosarcoma, Smooth muscle tumor, Uterine neoplasms",
author = "Giuntoli, {Robert L.} and Gostout, {Bobbie S.} and DiMarco, {Connie S.} and Metzinger, {Daniel S.} and Gary Keeney",
year = "2007",
month = "11",
language = "English (US)",
volume = "52",
pages = "1001--1010",
journal = "The Journal of reproductive medicine",
issn = "0024-7758",
publisher = "Donna Kessel",
number = "11",

}

TY - JOUR

T1 - Diagnostic criteria for uterine smooth muscle tumors

T2 - Leiomyoma variants associated with malignant behavior

AU - Giuntoli, Robert L.

AU - Gostout, Bobbie S.

AU - DiMarco, Connie S.

AU - Metzinger, Daniel S.

AU - Keeney, Gary

PY - 2007/11

Y1 - 2007/11

N2 - OBJECTIVE: To determine the prognostic accuracy of current diagnostic criteria for uterine smooth muscle tumors. STUDY DESIGN: Cases of uterine leiomyosarcoma (LMS) treated from 1976 to 1999 were analyzed retrospectively. Uterine LMS specimens were reevaluated using current criteria by a pathologist specializing in gynecologic diseases. Kaplan-Meier survival curves were evaluated. RESULTS: Specimens were available from 67 patients diagnosed with uterine LMS. On rereview, only 47 specimens were thought to represent uterine LMS. The 20 other patients were deemed to have leiomyomas or leiomyoma variants, including 13 cellular leiomyomas, 5 atypical leiomyomas and 2 leiomyomas. Median survival for patients with uterine LMS was 2.1 years. (Ninety-seven percent of disease-specific deaths occurred within 6 years after the diagnosis.) With leiomyoma variants, median survival was >25 years. Among these 18 women were 3 disease-specific deaths (all > 6 years after diagnosis). CONCLUSION: Diagnostic criteria for uterine smooth muscle tumors require continued refinement. A small but significant number of patients diagnosed with leiomyoma variants will die of the disease. In contrast to the aggressive behavior of uterine LMS, disease-specific deaths attributed to leiomy oma variants occurred later. With this potential for delayed recurrence, these patients warrant close clinical surveillance.

AB - OBJECTIVE: To determine the prognostic accuracy of current diagnostic criteria for uterine smooth muscle tumors. STUDY DESIGN: Cases of uterine leiomyosarcoma (LMS) treated from 1976 to 1999 were analyzed retrospectively. Uterine LMS specimens were reevaluated using current criteria by a pathologist specializing in gynecologic diseases. Kaplan-Meier survival curves were evaluated. RESULTS: Specimens were available from 67 patients diagnosed with uterine LMS. On rereview, only 47 specimens were thought to represent uterine LMS. The 20 other patients were deemed to have leiomyomas or leiomyoma variants, including 13 cellular leiomyomas, 5 atypical leiomyomas and 2 leiomyomas. Median survival for patients with uterine LMS was 2.1 years. (Ninety-seven percent of disease-specific deaths occurred within 6 years after the diagnosis.) With leiomyoma variants, median survival was >25 years. Among these 18 women were 3 disease-specific deaths (all > 6 years after diagnosis). CONCLUSION: Diagnostic criteria for uterine smooth muscle tumors require continued refinement. A small but significant number of patients diagnosed with leiomyoma variants will die of the disease. In contrast to the aggressive behavior of uterine LMS, disease-specific deaths attributed to leiomy oma variants occurred later. With this potential for delayed recurrence, these patients warrant close clinical surveillance.

KW - Leiomyoma

KW - Leiomyoma variants

KW - Leiomyosarcoma

KW - Smooth muscle tumor

KW - Uterine neoplasms

UR - http://www.scopus.com/inward/record.url?scp=37348999883&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=37348999883&partnerID=8YFLogxK

M3 - Article

C2 - 18161397

AN - SCOPUS:37348999883

VL - 52

SP - 1001

EP - 1010

JO - The Journal of reproductive medicine

JF - The Journal of reproductive medicine

SN - 0024-7758

IS - 11

ER -