The Clinicopathological Features and Survival Prediction of Gastrointestinal Leiomyosarcoma: A SEER Based Analysis

Abstract

Background There is still lacking knowledge and awareness of patients with gastrointestinal leiomyosarcomas (GILMS). This study aimed to clarify the disease features and prognosis of GILMS based on Surveillance, Epidemiology, and End Results (SEER) database. Methods Clinicopathological, treatment, survival, and prognostic data of GILMS from 2000–2020 were retrieved. Appropriate statistical approaches were used to evaluate the demographic features and survival outcomes. Results A total of 479 GILMS cases conformed the screening criterion. The median age of patients was 64 (15–90) years. Only 7.9% of these cases were diagnosed with lymph node metastasis. 78.1% of patients were diagnosed at T2 or higher primary tumor extension. The 5-year cancer specific survival (CSS) of patients undergone surgery was 66.5%, and 5-CSS for patients without surgery was 0. Multivariate Cox proportional hazards analysis based on both overall survival (OS) and CSS showed Female was significant independent protective factor. Significant independent risk factors included: age at 65–79 years, age ≥ 80, poor differentiation, T2 and higher T stage, distant metastasis, and without surgery. Both chemotherapy and radiotherapy performed no influence on survival and prognosis. Conclusion GILMS was commonly diagnosed in old patients with low rate of nodal and distant metastasis. Whereas most GILMS was presented with large tumor size and high extent of tumor invasion. Complete excision was demonstrated to be the unique way to prolong survival outcomes. Chemotherapy and radiotherapy can’t bring benefits on survival and prognosis highlighting the urgent need for exploration of effective systematic treatments.