{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T16:14:04Z","timestamp":1788279244375,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Risk factors for dermal leiomyosarcoma (dLMS) metastasis remain poorly defined because methodological constraints, small sample sizes, and short follow\u2010up have limited previous studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate risk factors for metastasis and local recurrence, and to propose a high\u2010 and low\u2010risk classification for dLMS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All patients diagnosed with dLMS in Denmark between 1980 and 2022 were included. Absolute 5\u2011year risks were estimated using the Aalen\u2010Johansen method, treating all\u2011cause mortality as a competing risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 381 patients (median age 66 years, 71% male), the 5\u2010year risk of metastasis was 2.4% and 10% for local recurrence. The most important risk factors for metastasis were tumor necrosis, mitotic grade 3, and perineural\/intravascular invasion, with 5\u2010year absolute risks ranging between 9% and 25%. Positive surgical margins and perineural\/intravascular invasion were associated with increased 5\u2010year absolute risks of local recurrence, ranging between 26% and 50%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although few distant metastases were observed, high\u2010risk dLMS features may include tumor necrosis, mitotic grade 3, perineural\/intravascular invasion, or positive surgical margins. Cases without these features may be classified as low\u2010risk dLMS. We propose regular cross\u2010sectional imaging in the follow\u2010up of patients with high\u2010risk dLMS, whereas follow\u2010up for patients with low\u2010risk dLMS could be limited to clinical examinations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jso.70308","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T19:12:06Z","timestamp":1781550726000},"page":"394-402","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Classification of High\u2010 and Low\u2010Risk Patients With Dermal Leiomyosarcoma: An Exploratory Nationwide Cohort Study"],"prefix":"10.1002","volume":"134","author":[{"given":"Kiya","family":"Abebe","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery and Burns Treatment Copenhagen University Hospital, Rigshospitalet Copenhagen Denmark"},{"name":"Department of Surgery Helse Fonna, Haugesund Hospital Haugesund Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Munch","sequence":"additional","affiliation":[{"name":"Section of Biostatistics University of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Lene","family":"Wagenblast","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Herlev University Hospital Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grethe","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery and Burns Treatment Copenhagen University Hospital, Rigshospitalet Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Hebbelstrup","family":"Jensen","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Odense University Hospital Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael M.","family":"Petersen","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Musculoskeletal Tumor Section Copenhagen University Hospital, Rigshospitalet Copenhagen Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anand C.","family":"Loya","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine University of Copenhagen Copenhagen Denmark"},{"name":"Department of Pathology Copenhagen University Hospital, Rigshospitalet Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f8ren","family":"Daugaard","sequence":"additional","affiliation":[{"name":"Department of Pathology Copenhagen University Hospital, Rigshospitalet Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Mentzel","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Freiburg Freiburg im Breisgau Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikkel","family":"Herly","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery and Burns Treatment Copenhagen University Hospital, Rigshospitalet Copenhagen Denmark"},{"name":"Department of Immunology and Microbiology University of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Vester\u2010Glowinski","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery and Burns Treatment Copenhagen University Hospital, Rigshospitalet Copenhagen Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8815-8392","authenticated-orcid":false,"given":"Mathias","family":"\u00d8rholt","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery and Burns Treatment Copenhagen University Hospital, Rigshospitalet Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"issue":"3","key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/j.jaad.2024.10.033","article-title":"No Difference in Prognosis Between Atypical Intradermal Smooth Muscle Neoplasms and Dermal Leiomyosarcoma: Local Recurrence, Metastasis, and Overall Survival in a Nationwide Cohort of 423 Patients","volume":"92","author":"Abebe K.","year":"2025","journal-title":"Journal of the American Academy of Dermatology"},{"issue":"7","key":"e_1_2_13_3_1","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1111\/j.1524-4725.1996.tb00609.x","article-title":"Leiomyosarcoma of the Skin: Treatment of 34 Cases","volume":"22","author":"Bernstein S. 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