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Wide local excision, MMS may be best approach for leiomyosarcoma treatment
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For leiomyosarcoma of the skin, wide local excision and Mohs micrographic surgery may provide the best approach for treatment, according to researchers.
In a retrospective review, 71 cases of primary superficial leiomyosarcoma (LMS) were examined; 48 tumors were dermal and 23 were subcutaneous. The researchers then reported on clinical, histopathologic and treatment factors.
The researchers studied four treatment modalities for recurrences, metastasis or disease-specific death: local excision with narrow surgical margins defined, wide local excision with a minimum of 1-cm margin, wide local excision plus radiation and Mohs micrographic surgery.
There was a significantly lower rate of recurrence and metastasis in the group treated with wide local excision with at least 1-cm margins than in patients treated through excision with narrow surgical margins, according to the researchers.
Among the 14 cases treated by Mohs micrographic surgery, there were no cases of recurrences, metastasis or disease-specific death at a mean follow-up of 5.6 years.
The researchers found an overall recurrence rate for LMS of 22% at 5 years. Although dermal LMS was found to have a lower 5-year recurrence rate compared with subcutaneous LMS, the difference was not statistically significant, according to the researchers.
Of the five cases of dermal LMS that metastasized, two resulted in death.
Disclosure: The authors have no relevant financial disclosures.
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