Gastric leiomyosarcoma. Prognostic factors and surgical management
C. S. Grant, C. H. Kim, G. Farrugia, A. Zinsmeister and J. R. Goellner
Department of Surgery, Mayo Clinic, Rochester, Minn.
Information on gastric leiomyosarcoma, such as important prognostic
factors, patterns of disease recurrence, and optimal methods of treatment,
are derived from limited patient experience. We address these questions,
with specific focus on whether an advantage could be demonstrated for
radical resection compared with wide local excision, by retrospectively
investigating 53 patients who underwent surgical treatment at Mayo Clinic,
Rochester, Minn. Abdominal pain and/or gastrointestinal bleeding associated
with an intramural or exogastric mass were typical features of this
disease. Only tumor size and histologic grade were statistically
significant prognostic factors. With analysis of survival curves and
patterns of recurrence, neither the addition of lymphadenectomy nor the
wider tumor-free margins of a radical gastrectomy seemed superior to the
more conservative local excision. Therefore, wide local excision remains
the preferred treatment when technically feasible.
