Recent Treatment Options for Primary Colonic Leiomyosarcoma: A Case Report and a Review of the Literature

Cancer research · Colorectal cancer · TP53

In select patients with primary colonic leiomyosarcoma, minimally invasive laparoscopic resection followed by adjuvant doxorubicin‑ and ifosfamide‑based chemotherapy may be effective and result in disease‑free survival.

Primary colonic leiomyosarcoma (LMS) is an exceedingly rare tumour, comprising only 0.12 % of colonic malignancies. It is highly aggressive with a poor prognosis and treatment guidance is limited by sparse case data. Radical surgical resection constitutes the mainstay of therapy, but the ideal operative technique (open versus minimally invasive) and the benefit of adjuvant chemotherapy remain uncertain. This case report describes a 45‑year‑old man with a 40‑mm sigmoid‑colon LMS who underwent laparoscopic sigmoidectomy with lymph‑node dissection followed by six cycles of doxorubicin and ifosfamide. The patient remained disease free at 42 months. A review of the limited literature suggests that laparoscopic resection is feasible for LMS <5 cm and that doxorubicin‑based chemotherapy may confer a survival advantage in high‑grade tumours, but robust evidence is lacking.

The case adds to the growing evidence that minimally invasive surgery combined with adjuvant doxorubicin‑ifosfamide chemotherapy can achieve durable disease control in primary colonic LMS, informing clinicians when routine adjuvant therapy may be considered in similar high‑risk patients.

Evidence level: Számítógépes vagy elméleti. Modellből vagy adatbányászatból származó jel.

Original source

Related signals