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Peer-reviewedCC BYJournal of clinical medicine

Clinical Heterogeneity and Survival Disparities in Leiomyosarcoma: An Exploratory Single-Center Retrospective Observational Study

  • Rakesh Pinninti1
  • Kiruthika Subramaniyan1
  • Rajagopalan Iyer2
  • Tasneem Rushdi3
  • Harveen Kaur Gulati4
  • Naga Prasanthi Akkineni3
  • Srinath Gupta2
  • Krishna Mohan Mallavarapu1
  • Yashaswini Nallacheruvu4
  • Sujit Chyau Patnaik2
  • Santa Ayyagari1
  • Suseela Kodandapani4
4 more authors
  • Veeraiah Koppula5
  • Deleep Gudipudi3
  • Subramanyeshwar Rao Thammineedi2
  • Senthil Rajappa1
5 affiliations
  1. 1Medical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad 500082, India
  2. 2Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad 500082, India
  3. 3Radiation Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad 500082, India
  4. 4Pathology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad 500082, India
  5. 5Radiodiagnosis, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad 500082, India
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Abstract

Background: Leiomyosarcoma (LMS) is a rare aggressive sarcoma with substantial heterogeneity in anatomical presentation, stage, treatment, and survival. We evaluated clinical characteristics, treatment patterns, and survival, with particular emphasis on whether anatomical site independently predicted overall survival (OS). Methods: We retrospectively reviewed 240 adults with histologically confirmed LMS diagnosed between January 2015 and May 2026. OS was calculated from diagnosis to death or last contact, with administrative censoring on 1 July 2026. Kaplan–Meier and Cox proportional-hazards methods were used to evaluate age, sex, anatomical site, histologic grade, and disease stage. Multivariable models adjusted for age, sex, grade, and stage assessed the independent association of anatomical site with OS. Results: Median age was 56 years, and 152 patients (63.3%) were female. Disease was localized in 120 (50.0%), de novo metastatic in 53 (22.1%), recurrent metastatic in 35 (14.6%), and recurrent localized in 12 (5.0%). Median OS was 37.0 months. Localized disease was associated with substantially longer OS than metastatic disease (61.0 vs. 13.0 months; p < 0.001). Grade 3 disease was associated with shorter OS than grade 1/2 disease (25.6 vs. 61.1 months; p < 0.001). In multivariable analyses, metastatic disease remained strongly associated with inferior OS (HR, 5.59–5.94; p < 0.001), as did age ≥ 50 years (HR, 1.86–1.92; p = 0.006–0.004) and grade 3 histology (HR, 1.74–1.92; p = 0.018–0.007). Anatomical site was not independently associated with OS (extremity/trunk vs. non-extremity: HR, 1.60; p = 0.063; non-uterine vs. uterine: HR, 1.23; p = 0.41). Conclusions: Disease stage was the strongest prognostic factor, while older age and grade 3 histology were independently associated with poorer OS. Although extremity/trunk LMS showed better univariable survival, anatomical site was not independently associated with OS after adjustment.

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Cite

BibTeXRIS
BibTeX
@article{pinninti2026clinical,
  title = {{Clinical Heterogeneity and Survival Disparities in Leiomyosarcoma: An Exploratory Single-Center Retrospective Observational Study}},
  author = {Rakesh Pinninti and Kiruthika Subramaniyan and Rajagopalan Iyer and Tasneem Rushdi and Harveen Kaur Gulati and Naga Prasanthi Akkineni and Srinath Gupta and Krishna Mohan Mallavarapu and Yashaswini Nallacheruvu and Sujit Chyau Patnaik and Santa Ayyagari and Suseela Kodandapani and Veeraiah Koppula and Deleep Gudipudi and Subramanyeshwar Rao Thammineedi and Senthil Rajappa},
  journal = {Journal of clinical medicine},
  year = {2026},
  month = oct,
  doi = {10.3390/jcm15197693},
  url = {https://europepmc.org/article/PMC/PMC13666196},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Clinical Heterogeneity and Survival Disparities in Leiomyosarcoma: An Exploratory Single-Center Retrospective Observational Study
AU  - Rakesh Pinninti
AU  - Kiruthika Subramaniyan
AU  - Rajagopalan Iyer
AU  - Tasneem Rushdi
AU  - Harveen Kaur Gulati
AU  - Naga Prasanthi Akkineni
AU  - Srinath Gupta
AU  - Krishna Mohan Mallavarapu
AU  - Yashaswini Nallacheruvu
AU  - Sujit Chyau Patnaik
AU  - Santa Ayyagari
AU  - Suseela Kodandapani
AU  - Veeraiah Koppula
AU  - Deleep Gudipudi
AU  - Subramanyeshwar Rao Thammineedi
AU  - Senthil Rajappa
PY  - 2026
DA  - 2026/10/01
JO  - Journal of clinical medicine
DO  - 10.3390/jcm15197693
UR  - https://europepmc.org/article/PMC/PMC13666196
AB  - Background: Leiomyosarcoma (LMS) is a rare aggressive sarcoma with substantial heterogeneity in anatomical presentation, stage, treatment, and survival. We evaluated clinical characteristics, treatment patterns, and survival, with particular emphasis on whether anatomical site independently predicted overall survival (OS). Methods: We retrospectively reviewed 240 adults with histologically confirmed LMS diagnosed between January 2015 and May 2026. OS was calculated from diagnosis to death or last contact, with administrative censoring on 1 July 2026. Kaplan–Meier and Cox proportional-hazards methods were used to evaluate age, sex, anatomical site, histologic grade, and disease stage. Multivariable models adjusted for age, sex, grade, and stage assessed the independent association of anatomical site with OS. Results: Median age was 56 years, and 152 patients (63.3%) were female. Disease was localized in 120 (50.0%), de novo metastatic in 53 (22.1%), recurrent metastatic in 35 (14.6%), and recurrent localized in 12 (5.0%). Median OS was 37.0 months. Localized disease was associated with substantially longer OS than metastatic disease (61.0 vs. 13.0 months; p < 0.001). Grade 3 disease was associated with shorter OS than grade 1/2 disease (25.6 vs. 61.1 months; p < 0.001). In multivariable analyses, metastatic disease remained strongly associated with inferior OS (HR, 5.59–5.94; p < 0.001), as did age ≥ 50 years (HR, 1.86–1.92; p = 0.006–0.004) and grade 3 histology (HR, 1.74–1.92; p = 0.018–0.007). Anatomical site was not independently associated with OS (extremity/trunk vs. non-extremity: HR, 1.60; p = 0.063; non-uterine vs. uterine: HR, 1.23; p = 0.41). Conclusions: Disease stage was the strongest prognostic factor, while older age and grade 3 histology were independently associated with poorer OS. Although extremity/trunk LMS showed better univariable survival, anatomical site was not independently associated with OS after adjustment.
SN  - 2077-0383
ER  -