Prognosis

Leiomyosarcoma Prognosis

There are some diseases that don’t provide any clear statistics or survival rates. Leiomyosarcoma (LMS) is one of them. Not only is this a rare form of cancer, occurring in less than one percent of patients with sarcomas, but sarcomas themselves are also fairly rare. In the U.S. each year there are only a few thousand cases of LMS diagnosed, and these can range very widely in terms of their location and severity.

LMS is a cancer of the soft tissue, and because it impacts the involuntary muscles it can appear almost anywhere on the body. However, it is known that the most common locations include the uterus, limbs, and the trunk of the body (most often in the retroperitoneal area). The condition can be local (meaning a single sarcoma or tumor is present) or it can be systemic, meaning it has spread to other tissue or organs.

The first step in any LMS diagnosis is “staging” the condition. This can involve taking a biopsy from a single local tumor and looking at its cells. This tells the pathologist if the changes in the cells are mild or not all that detectable or if there has been a lot of alteration.

The Importance of Staging

When cancer strikes any tissue or organ, it causes changes in the DNA. Over time, the unhealthy cells multiply and continue to change. When a biopsy shows tremendous changes in the tissue, it means that the condition has become quite serious, and the cancer is likely to spread.

This is why the staging process is important in determining the appropriate treatment and giving the patient an accurate prognosis. For example, when an LMS patient has a tumor staged at 1A or 1B, it is likely that the tumor will be able to be surgically removed and that the treatment will halt the spread of the disease.

Stages

Physicians use the AJCC system for staging LMS tumors, and all staging uses a very simple alphanumeric designation. This rates tumors from the mildest to most severe stages, and the system looks like this:

• 1A – low grade/less than 5cm in size/can be superficial or deep/no metastatic disease
• 1B – low grade/more or less than 5 cm in size/superficial/no metastatic disease
• 2A – low grade/more or less than 5 cm in size/deep/no metastatic disease
• 2B – high grade/less than 5 cm in size/can be superficial or deep/no metastatic disease
• 2C – high grade/more or less than 5 cm in size/superficial/no metastatic disease
• 3 – high grade/more or less than 5 cm in size/deep/no metastatic disease
• 4 – any grade/any size/any location/metastatic disease

The term “grade” applies to the changes in the tissue, and so a low-grade tumor is one in which cells have not differentiated much from the original tissue. This is, obviously, a good sign and demonstrates that the condition has been caught early and can be dealt with very aggressively.

The high-grade tumors are those that do not have the best prognosis simply because they are much more likely to spread quickly. In fact, when a patient is staged at 3 or 4, it is often going to be LMS that takes their life. The survival rates for LMS are unclear due to the diversity of places it appears in the body and the inconsistencies in catching it early. However, when it is a high-grade case or has metastasized, it has gone systemic.

Generally, LMS is a very aggressive disease that is difficult to treat with chemotherapy or radiation alone. When systemic, though, these are the only treatment options. Early detection, surgical removal, and aggressive follow up can provide patients with an impressive prognosis, and so it is best for patients to head to a physician at the first sign of any symptoms relating to LMS condition.

Source

NLMSF.org. Treatments. 2015. http://www.nlmsf.org/what-is-lms/treatments/