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Leiomyosarcoma in the extremities and trunk wall: systematic review and meta-analysis of the oncological outcomes

Lookup NU author(s): Sudhir Kannan, Dr Kenneth RankinORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© 2022, The Author(s). Background: Leiomyosarcomas are aggressive malignancies which can occur on the trunk and extremities whose pathogenesis is poorly understood. We aim to quantify the prognostic impact of various clinical and pathological markers on survival and recurrence of leiomyosarcomas. Methods: We conducted a systematic review as per PRISMA protocol. Survival, local recurrence, and metastasis were the outcome measures. Data were extracted from the studies for the outcome variables; the resultant odds ratios (OR) and 95% confidence interval (CI) were used for the synthesis of a forest plot. Results: Our search revealed thirteen studies comprising 1380 patients. Seven of these 13 publications were since 2012. Our analysis showed that tumor size larger than 5 cm adversely affected the outcome with an OR 3.39 (2.26–5.10, p < 0.01). Other factors which reduced the overall survival were positive margins of excision OR 2.12 (1.36–3.32, p < 0.01). A reduced risk of metastasis has strongly associated the use of radiotherapy with OR 10.84 (4.41–26.61, p < 0.01). Only a few studies analyzed the impact of factors on local recurrence. Conclusions: Size larger than 5 cm and positive margins of excision are associated with poor overall survival. In comparison, the use of adjuvant radiotherapy was associated with a lower metastatic rate. There is a need for methodically high-quality studies with more uniform study design and reporting to evaluate the impact of various risk factors on local recurrence and metastases. Level of evidence: Level 1 Prognostic

Publication metadata

Author(s): Kannan S, Chong HH, Chew B, Ferguson JD, Galloway E, McCulloch T, Rankin KS, Ashford RU

Publication type: Review

Publication status: Published

Journal: World Journal of Surgical Oncology

Year: 2022

Volume: 20

Issue: 1

Online publication date: 18/04/2022

Acceptance date: 31/03/2022

ISSN (electronic): 1477-7819

Publisher: BioMed Central Ltd


DOI: 10.1186/s12957-022-02584-4

PubMed id: 35436892