Introduction/Background Leiomyosarcoma (LMS) is the most common subtype of uterine sarcomas (US). These tumors are aggressive. The aim of our study was to assess the clinical characteristics and therapeutic outcomes of uterine leiomyosarcoma.

Methodology We conducted a monocentric retrospective descriptive study that included patients with uterine LMS (uLMS) treated at Salah Azaiez Institute between 2000 and 2022. Survival outcomes were evaluated by Kaplan-Meier survival analysis

Results The study included 80 patients. The average age was 50 years. The FIGO distribution was: Stage I in 33 patients (41%), stage II in 16 patients (20%), stage III in 7 patients (9%) and stage IV in 24patients (30%). Lung was the most frequent site of metastases (41%). Surgery was performed in 77 patients. A total hysterectomy associated with bilateral salpingo-oophorectomy and lymph node dissection were performed in 63 patients. 29 patients received adjuvant pelvic radiotherapy, 14 received adjuvant chemotherapy and one patient received neoadjuvant chemotherapy. 22 patients received palliative first line chemotherapy. During follow up, 39 % of non-metastatic patients relapsed. The most common site of recurrence was the peritoneum in 13 patients. The median survival was 30 months. The overall survival was 50% and 33% at 2 and 5 years, respectively.Complete resection, adjuvant radiotherapy and a good performans status were significantly associated with better overall survival (p<0.001, p=0,002 and p=0.001, respectively).

Conclusion ULMS is an aggressive tumor associated with a high risk of recurrence. uLMS is still a challenging neoplasm and novel early detection strategies and personalized treatment are required.

Disclosures The authors have no conflicts of interest to declare.