Skip to main content

Advertisement

Log in

Gastrointestinal Stromal Tumors and Leiomyosarcoma of the Abdomen and Retroperitoneum: A Clinical Comparison

  • Original Articles
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. 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.

    PubMed  CAS  Google Scholar 

  2. 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.

    Google Scholar 

  3. 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.

    CAS  PubMed  Google Scholar 

  4. Starr G, Dockerty M. Leiomyomas and leiomyosarcomas of the small intestine. Cancer 1955; 8: 101–11.

    CAS  PubMed  Google Scholar 

  5. 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.

    CAS  PubMed  Google Scholar 

  6. 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.

    Article  CAS  PubMed  Google Scholar 

  7. Sondak V, Economou J, Eilber F. Soft tissue sarcomas of the extremity and retroperitoneum: advances in management. Adv Surg 1991; 24P: 333–59.

    Google Scholar 

  8. Van Dam P, Lowe D, McKenzie-Gray B, Shepherd J. Retroperitoneal soft tissue sarcomas. Obstet Gynecol Surv 1990; 45: 670–82.

    CAS  PubMed  Google Scholar 

  9. 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.

    CAS  PubMed  Google Scholar 

  10. NgE, Pollock R, Romsdahl M. Prognostic implications of patterns of failure for gastrointestinal leiomyosarcomas. Cancer 1992; 69: 1334–41.

    CAS  PubMed  Google Scholar 

  11. Lee Y. Leiomyosarcoma of the gastro-intestinal tract: general pattern of metastasis and recurrence. Cancer Treat Rev 1983; 10: 91–101.

    CAS  PubMed  Google Scholar 

  12. 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.

    Article  CAS  PubMed  Google Scholar 

  13. Todd C, Michael H, Sutton G. Retroperitoneal leiomyosarcoma: eight cases and a literature review. Gynecol Oncol 1995; 59: 333–7.

    CAS  PubMed  Google Scholar 

  14. Shmookler B, Lauer D. Retroperitoneal leiomyosarcoma: a clinicopathologic analysis of 36 cases. Am J Surg Pathol 1983; 7: 269–80.

    CAS  PubMed  Google Scholar 

  15. Kay S, McNeill D. Leiomyosarcoma of the retroperitoneum. Surg Gynecol Obstet 1969; 129: 285–8.

    CAS  PubMed  Google Scholar 

  16. de Waele B, van Belle S, Claes H, Goovaerts G, Delvaux G, Willems G. Retroperitoneal leiomyosarcoma. Acta Chir Belg 1987; 87: 229–34.

    CAS  PubMed  Google Scholar 

  17. Gadducci A, Landoni F, Sartori E, et al. Uterine leiomyosarcoma: analysis of treatment failures and survival. Gynecol Oncol 1996; 62: 25–32.

    CAS  PubMed  Google Scholar 

  18. 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.

    Article  CAS  PubMed  Google Scholar 

  19. 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.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Murray F. Brennan MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Clary, B.M., DeMatteo, R.P., Lewis, J.J. et al. Gastrointestinal Stromal Tumors and Leiomyosarcoma of the Abdomen and Retroperitoneum: A Clinical Comparison. Ann Surg Oncol 8, 290–299 (2001). https://doi.org/10.1007/s10434-001-0290-3

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10434-001-0290-3

Key Words:

Navigation