Study findings on leiomyosarcoma are outlined in reports from University of Vienna, Medical Department

2009 JAN 5 -- "Uterine leiomyosarcoma during pregnancy is an extremely rare event. The incidence of meningioma during pregnancy is comparable with that in nonpregnant women of the same age group," investigators in Vienna, Austria report.

"We report a case of both - a primary uterine leiomyosarcoma and additionally all atypical meningioma of the brain both diagnosed during pregnancy. The patient was admitted with generalised seizures at 31 weeks of gestation. A tumoural mass was detected and initial conservative treatment was started. The patient delivered her infant via caesarean section, at 34 weeks of gestation. During caesarean section a pedunculated uterine fibroid was removed and total gross resection due to the brain tumour was also performed. Histopathological diagnosis of both tumours revealed an atypical meningioma of the brain and a uterine leiomyosarcoma. The patient underwent laparatomy and received six cycles of adjuvant chemotherapy. We are the first to report a case of a woman with two separate primary neoplasms both diagnosed during pregnancy," wrote B. Bodneradler and colleagues, University of Vienna, Medical Department.

The researchers concluded: "Treatment options seem to be reduced in pregnant women and mainly depend on the patient's condition as well as the gestational age at presentation."

Bodneradler and colleagues published their study in Anticancer Research (Primary Uterine Leiomyosarcoma and Primary Atypical Meningioma Diagnosed during Pregnancy. Anticancer Research, 2008;28(5B):3083-3085).

For additional information, contact B. Bodneradler, University of Vienna, School Medical, Dept. of Obstetrics & Gynecology, Wahringer Gurtel 18-20, A-1090 Vienna, Austria.

The publisher of the journal Anticancer Research can be contacted at: International Institute Anticancer Research, Editorial Office 1ST km Kapandritiou-Kalamou Rd. Kapandriti, PO Box 22, Athens 19014, Greece.

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New findings from M.C. Cercato and co-authors in the area of carcinoma published

2009 JAN 5 -- "Multiple primary malignant neoplasms (MPMN) ore not uncommon, however, finding more than three primary malignancies in one individual is unusual. Surviving five malignancies is considered exceptional," scientists in Rome, Italy report.

"Two patients surviving five primary malignant neoplasms for 12 and 18 years are reported: a 55-year-old woman with a squamous cell carcinoma of the larynx, two carcinomas of the breast, a carcinoma of the kidney and an adenocarcinoma of the colon, and a 75-year-old woman with a sarcoma of the myometrium, a carcinoma of the thyroid, an adenocarcinoma of the rectum a leiomyosarcoma of the colon and a bronchial carcinoid. Only twelve other reported cases with five or more primary infiltrating malignancies involving more than three sites. diagnosed while the patient was alive have been found," wrote M.C. Cercato and colleagues.

The researchers concluded: "Relevant features were that colon cancer was quite often present more than once and survival was longer than expected for the stage (median overall survival, 20 Years: 95% confidence interval: 12-28 years)."

Cercato and colleagues published their study in Anticancer Research (Report of Two Cases of Quintuple Primary Malignancies and Review of the Literature. Anticancer Research, 2008;28(5B):2953-2958).

For additional information, contact M.C. Cercato, Italian National Cancer Institute Regina Elena, Dept. of Epidemiology, Via Elio Chianesi 53, I-00144 Rome, Italy.

The publisher's contact information for the journal Anticancer Research is: International Institute Anticancer Research, Editorial Office 1ST km Kapandritiou-Kalamou Rd. Kapandriti, PO Box 22, Athens 19014, Greece.

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PET Scans and LMS

Fluorodeoxyglucose positron emission tomography in leiomyosarcoma:
imaging characteristics.

Nucl Med Commun. 2009 May 13. [Epub ahead of print]

Punt SE, Eary JF, Oʼsullivan J, Conrad EU.
aDepartments of Radiology and Orthopedics, University of Washington,
Seattle, Washington, USA bDepartment of Statistics, University
College, Cork, Ireland.

OBJECTIVE: Leiomyosarcoma, a malignant neoplasm of smooth muscle,
accounts for 7% of the sarcomas. Patients with leiomyosarcoma tumors
have an average survival of 5 years. These tumors, which are derived
from mesenchymal tissues, are difficult to diagnose, and treatment
options remain controversial. The relatively rare incidence of this
soft tissue sarcoma subtype has limited the number of patients
available for studies and research. This study examines whether the
imaging characteristics of positron emission tomography (PET) with
radiolabeled fluorodeoxyglucose (FDG) provide a reliable, noninvasive
means to predict tumor behavior in patients with leiomyosarcomas.

METHODS: [F]-FDG-PET was performed on the tumors of participating
patients before the neoadjuvant chemotherapy or resection, and a
maximum tumor standard uptake value (SUVmax) was calculated.

RESULTS: The SUVmax was correlated with tumor grade (P=0.001) and
tumor size as greatest dimension (P=0.004). Analysis of these data
indicated the potential effectiveness of FDG-PET imaging in predicting
tumor grade.

CONCLUSION: In leiomyosarcoma, the SUVmax from FDG-PET is a likely
predictor of tumor behavior. The results of this study suggest that a
large (by greatest dimension) intermediate grade tumor is expected to
have the same predicted outcome as a high-grade tumor and should be
treated in the same manner, as they share the same prognosis by
definition of tumor grade. Improvements made in the clinical treatment
of leiomyosarcomas by use of FDG-PET imaging data may lead to an
increase in patient survival.

PMID: 19440162

Ginger Found to Ease Nausea of Cancer Treatment

Grandma was right when she recommended ginger for an upset stomach — at least for cancer patients.

A randomized clinical trial has confirmed what many people suspect — that ginger can decrease nausea caused by chemotherapy. The effect goes beyond that provided by standard anti-vomiting drugs.

The results will be presented at the annual meeting of the American Society of Clinical Oncology, which begins May 29 in Orlando, Fla. Abstracts of most of the studies to be presented at the conference were made public Thursday.

NYTimes Full Article

Myocardin gene amplification in most human retroperitoneal LMS

Strong smooth muscle differentiation is dependent on myocardin gene
amplification in most human retroperitoneal leiomyosarcomas.

Cancer Res. 2009 Mar 15;69(6):2269-78. Epub 2009 Mar 10.

Pérot G, Derré J, Coindre JM, Tirode F, Lucchesi C, Mariani O, Gibault
L, Guillou L, Terrier P, Aurias A.
Genetics and Biology of Cancers, Institut Curie, Paris, France.

Myocardin (MYOCD), a serum response factor (SRF) transcriptional
cofactor, is essential for cardiac and smooth muscle development and
differentiation. We show here by array-based comparative genomic
hybridization, fluorescence in situ hybridization, and expression
analysis approaches that MYOCD gene is highly amplified and
overexpressed in human retroperitoneal leiomyosarcomas (LMS), a very
aggressive well-differentiated tumor. MYOCD inactivation by shRNA in a
human LMS cell line with MYOCD locus amplification leads to a dramatic
decrease of smooth muscle differentiation and strongly reduces cell
migration. Moreover, forced MYOCD expression in three undifferentiated
sarcoma cell lines and in one liposarcoma cell line confers a strong
smooth muscle differentiation phenotype and increased migration
abilities. Collectively, these results show that human retroperitoneal
LMS differentiation is dependent on MYOCD
amplification/overexpression, suggesting that in these
well-differentiated LMS, differentiation could be a consequence of an
acquired genomic alteration. In this hypothesis, these tumors would
not necessarily derive from cells initially committed to smooth muscle
differentiation. These data also provide new insights on the cellular
origin of these sarcomas and on the complex connections between
oncogenesis and differentiation in mesenchymal tumors.

PMID: 19276386

Early Outcomes of Soft Tissue Sarcomas Presenting With Metastases and Treated With Chemotherapy

Am J Clin Oncol. 2009 May 8.

King JJ, Fayssoux RS, Lackman RD, Ogilvie CM.
From the *Department of Orthopedic Surgery, Drexel University,
Philadelphia, PA; and daggerDepartment of Orthopedic Surgery,
University of Pennsylvania, Philadelphia, PA.

OBJECTIVES:: The purpose of this study is to describe outcomes for
patients with metastatic soft tissue sarcoma treated with
chemotherapy.

METHODS:: We retrospectively reviewed the records of 383 soft tissue
sarcoma patients treated at our institution from 1997 to 2006.
Thirty-five patients met the inclusion criteria-metastatic disease on
presentation; primary tumor outside the abdomen; treatment with
chemotherapy; and minimum follow-up of 3 months. Treatments were
individualized and determined by a multidisciplinary oncology team.
Patient survival was calculated from the diagnostic biopsy to the date
of death or last follow-up using the Kaplan-Meier method.

RESULTS:: Mean age was 47 years (range 17-74 years).

Most common tumors involved were MFH and leiomyosarcoma.

Sixteen of 35 (46%) patients had died at last follow-up. Mean patient
survival was 24 months (range 4-102). The 2-year and 5-year survival
rates were 64% and 24%, respectively. Twenty-nine patients (83%)
presented with pulmonary metastasis, 6 with bone metastases (17%), 4
with regional node metastases (11%), and 4 with soft tissue metastases
(11%). Survival was the same for those with pulmonary and only
extrapulmonary metastases. The 10 patients with complete resection or
complete chemotherapy response of all detectable lesions had longer
mean survival (34 months) than the 25 patients who had partial/no
resection or response (20 months) (P = 0.02).

CONCLUSIONS:: Soft tissue sarcoma patients presenting with metastatic
disease have a low survival rate, but complete eradication of tumor
correlated with longer survival. Longer-term studies especially those
tracking the outcome of complete responders and those completely
resected will help determine the efficacy of chemotherapy.

PMID: 19433963 [PubMed - as supplied by publisher]

Uterine sarcomas in Norway. A histopathological and prognostic surve

Uterine sarcomas in Norway. A histopathological and prognostic survey
of a total population from 1970 to 2000 including 419 patients.

Histopathology. 2009 Feb;54(3):355-64.

Abeler VM, Røyne O, Thoresen S, Danielsen HE, Nesland JM, Kristensen GB.
Division of Pathology, Radiumhospitalet, University Hospital, Oslo,
Norway. vera.maria.abeler@...

AIMS: To determine the frequency and survival of the various types of
uterine sarcoma in the total population of Norway and evaluate
histopathological prognostic factors in order to identify risk groups.

METHODS AND RESULTS: Histopathological review of all uterine sarcoma
cases reported to the Norwegian Cancer Registry during 1970-2000 was
undertaken. Survival dates were provided by The Cancer Registry.
Kaplan-Meier survival curves were generated. The log rank test was
used for univariate analysis and a Cox proportional hazards regression
model for multivariate evaluation of survival. Stage of disease was
the most important prognostic factor for all tumour types.

Tumour size and the mitotic index (MI) were significant prognostic
factors (P < 0.0001) in leiomyosarcomas confined to the uterus and
allowed for separation into three risk groups with marked differences
in prognosis.

The prognosis of endometrial stromal sarcomas confined to the uterus
was related to MI (P < 0.0001) and tumour cell necrosis (P < 0.004).
Combining these parameters allowed for separation into three risk
groups with marked difference in prognosis. In adenosarcomas, tumour
cell necrosis was the only significant prognostic factor.

CONCLUSIONS: There are marked differences in survival between uterine
sarcoma types. Leiomyosarcomas and endometrial stromal sarcomas can be
divided into different groups.

PMID: 19236512