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Open Access 17-08-2022 | Gynecologic Oncology

Clinical and Histopathological Predictors of Recurrence in Uterine Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP): A Multicenter Retrospective Cohort Study of Tertiary Centers

Authors: Fulvio Borella, MD, Stefano Cosma, MD, PhD, Domenico Ferraioli, MD, PhD, Isabelle Ray-Coquard, MD, PhD, Nicolas Chopin, MD, Pierre Meeus, MD, Vincent Cockenpot, MD, Giorgio Valabrega, MD, PhD, Giulia Scotto, MD, Margherita Turinetto, MD, Nicoletta Biglia, MD, PhD, Luca Fuso, MD, PhD, Luca Mariani, MD, PhD, Dorella Franchi, MD, Ailyn Mariela Vidal Urbinati, MD, Ida Pino, MD, Gianluca Bertschy, MD, Mario Preti, MD, Chiara Benedetto, MD, PhD, Isabella Castellano, MD, PhD, Paola Cassoni, MD, PhD, Luca Bertero, MD, PhD

Published in: Annals of Surgical Oncology | Issue 13/2022

Abstract

Background

The term uterine smooth muscle tumor of uncertain malignant potential (STUMP) indicates a rare, equivocal entity between benign leiomyomas and leiomyosarcomas. In the present study, we evaluated a comprehensive range of clinical, surgical, and pathological features in a large multicenter series of patients with STUMP to identify risk factors for recurrence.

Methods

This is a retrospective study performed by collecting consecutive cases diagnosed between January 2000 and December 2020 in five tertiary centers. Associations between STUMP recurrence and clinicopathological characteristics as well as surgical treatment modality were investigated.

Results

Eighty-seven patients affected by STUMP were considered. Of them, 18 cases (20.7%) recurred: 11 as leiomyosarcoma (LMS) and 7 as STUMP. The mean time to recurrence was 79 months. We found that fragmentation/morcellation, epithelioid features, high mitotic count, Ki-67 value > 20%, progesterone receptor (PR) < 83%, and p16 diffuse expression were associated with higher risk of recurrence and shorter recurrence-free survival (RFS). Furthermore, morcellation/fragmentation and mitotic count remained independent risk factors for recurrence and shorter RFS after multivariate analysis, while the presence of epithelioid features was an independent risk factor for recurrence only.

Conclusions

Our results suggest that morcellation is associated with risk of recurrence and shorter RFS, thus it should be avoided if a STUMP is suspected preoperatively. Epithelioid features, high proliferation activity, low PR expression, and diffuse p16 expression are also unfavorable prognostic factors, so patients presenting these features should be closely followed up.

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Title: Clinical and Histopathological Predictors of Recurrence in Uterine Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP): A Multicenter Retrospective Cohort Study of Tertiary Centers
Authors: Fulvio Borella, MD
Stefano Cosma, MD, PhD
Domenico Ferraioli, MD, PhD
Isabelle Ray-Coquard, MD, PhD
Nicolas Chopin, MD
Pierre Meeus, MD
Vincent Cockenpot, MD
Giorgio Valabrega, MD, PhD
Giulia Scotto, MD
Margherita Turinetto, MD
Nicoletta Biglia, MD, PhD
Luca Fuso, MD, PhD
Luca Mariani, MD, PhD
Dorella Franchi, MD
Ailyn Mariela Vidal Urbinati, MD
Ida Pino, MD
Gianluca Bertschy, MD
Mario Preti, MD
Chiara Benedetto, MD, PhD
Isabella Castellano, MD, PhD
Paola Cassoni, MD, PhD
Luca Bertero, MD, PhD
Publication date: 17-08-2022
Publisher: Springer International Publishing
Published in: Annals of Surgical Oncology / Issue 13/2022
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-022-12353-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Clinical and Histopathological Predictors of Recurrence in Uterine Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP): A Multicenter Retrospective Cohort Study of Tertiary Centers

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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