{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T21:54:16Z","timestamp":1791237256306,"version":"4.1.0"},"reference-count":74,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"am","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"AZ CRUK Clinical Academic Training","award":["C60521\/A31343"],"award-info":[{"award-number":["C60521\/A31343"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Leiomyosarcoma, the most common subtype of soft tissue sarcoma, affects a wide range of anatomical sites. Few multi-site analyses of leiomyosarcoma have been performed to characterize differences across anatomical sites and to identify patient or tumor characteristics independently associated with survival. Such information is critical to inform the design of future trials that must include multiple disease sites due to the rarity of leiomyosarcoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed a study cohort of 11\u2009751 patients with leiomyosarcoma arising across a range of anatomical sites.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The uterus (36.3%), limbs (16.6%), superficial trunk (10.8%), and retroperitoneum (9.2%) were the most common anatomical sites affected. Median follow-up time was 8.4\u2009years. Uterine tumors accounted for a greater proportion of tumors in Black patients (adjusted P\u2009&amp;lt;\u2009.001), while the skin (adjusted P\u2009&amp;lt;\u2009.001) and limbs (adjusted P\u2009&amp;lt;\u2009.001) were more common sites in the White patient population. Marked differences in age, grade, and stage at diagnosis were observed across anatomical sites. Multivariable analysis identified site, grade, race, marital status, and household income as independently associated with outcome; individuals of Black race, widowed patients, and those with the lowest income demonstrated substantially shorter survival times. The uterus, urinary tract, and trunk were among the highest-risk sites, while the limbs, head and neck, and male reproductive tract were associated with more favorable outcomes after adjustment. ATRX mutations were enriched (adjusted P\u2009&amp;lt;\u2009.001) in uterine cases compared with other sites in a pooled analysis of publicly available sequencing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Major disparities in outcome are clear across leiomyosarcoma subgroups defined by anatomical site and patient characteristics. Future trials should consider the intrinsic aggressiveness of tumors arising at different anatomical locations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jnci\/djag284","type":"journal-article","created":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T12:47:15Z","timestamp":1786798035000},"source":"Crossref","is-referenced-by-count":1,"title":["Leiomyosarcoma survival across anatomical sites identifies high-risk and low-risk patient groups to inform clinical trial design"],"prefix":"10.1093","author":[{"given":"Ailsa J","family":"Oswald","sequence":"first","affiliation":[{"name":"The Nicola Murray Centre for Ovarian Cancer Research, Cancer Research UK Scotland Centre, Institute of Genetics and Cancer, University of Edinburgh ,","place":["United Kingdom"]},{"name":"Edinburgh Cancer Centre , Western General Hospital , Edinburgh,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashi","family":"Krishna","sequence":"additional","affiliation":[{"name":"The Nicola Murray Centre for Ovarian Cancer Research, Cancer Research UK Scotland Centre, Institute of Genetics and Cancer, University of Edinburgh ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangfei","family":"Yan","sequence":"additional","affiliation":[{"name":"Edinburgh Cancer Centre , Western General Hospital , Edinburgh,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Roxburgh","sequence":"additional","affiliation":[{"name":"School of Cancer Sciences, Wolfson Wohl Cancer Research Centre, University of Glasgow , Glasgow,","place":["United Kingdom"]},{"name":"Beatson West of Scotland Cancer Centre , Glasgow,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1390-3298","authenticated-orcid":false,"given":"Robert L","family":"Hollis","sequence":"additional","affiliation":[{"name":"The Nicola Murray Centre for Ovarian Cancer Research, Cancer Research UK Scotland Centre, Institute of Genetics and Cancer, University of Edinburgh ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"2026092703065397500_djag284-B1","doi-asserted-by":"publisher","first-page":"2922","DOI":"10.1002\/ijc.22239","article-title":"Incidence patterns of soft tissue sarcomas, regardless of primary site, in the surveillance, epidemiology and end results program, 1978-2001: an analysis of 26,758 cases","volume":"119","author":"Toro","year":"2006","journal-title":"Int J 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