Posters— Surgical Treatment of Sarcomas

PRIMARY LEIOMYOSARCOMA OF BONE. A CLINICOPATHOLOGIC STUDY OF 10 PATIENTS

Barabas D, Turcotte R, Isler M, Doyon J, Normandin D. (Division of Orthopaedic Surgery, Maisonneuve-Rosemont Hospital, Montreal, Qc H1T 4B3, Canada)

Backround and objectives: Primary leiomyosarcoma of bone (PLMSB) is a very rare malignant tumor with uncertain pathogenicity. In order to improve our understanding in pathological behaviour, prognostical predictors and treatment of this entity we proposed to review all PLMSB surgically treated in our department.

Methods and results: We retrospectively reviewed 10 patients (5 men and 5 women)with PLMSB treated between 1991-1999 in our department. The mean age was 57,2 years (30-79 years). The long bones were preferentially affected, tumor was localized in the lower limb in 8 patients and in the upper extremity in 2 patients.

At histology high grade tumor was found in 6 patients. Surgical resection was performed in all patients, a limb salvage surgery being possible in 9 patients. Surgical resection was completed by pre-and-postoperative chemotherapy in 2 patients and by postoperative radiotherapy in 3 patients. One patient had preoperative radiotherapy. The mean follow-up was 31,3 months (12-72 months). Five patients are alive with no evidence of disease, 4 patients died with disease and 1 patient is alive with lung metastasis. Metastases occured in 4 patients, mean time to metastasis was 16 months after surgery. In the 4 patients who died survival averaged 25 months.

Conclusions: Our experience concerning the diagnosis of PLMSB is similar to the reported data. There is an unclear relationship between histology and prognosis. Metastases occur early, they are a common cause of death. Survival at 2 years is 60%. Surgical treatment is the therapy of choice. Multiagent chemotherapy and radiotherapy did not seem to provide an improved prognosis over a simple ablative procedure.