{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T17:14:35Z","timestamp":1775841275990,"version":"3.50.1"},"reference-count":43,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2020,9,23]],"date-time":"2020-09-23T00:00:00Z","timestamp":1600819200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000325","name":"Wellbeing of Women","doi-asserted-by":"publisher","award":["RG1487 and RG2137"],"award-info":[{"award-number":["RG1487 and RG2137"]}],"id":[{"id":"10.13039\/501100000325","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NIHR ACF","award":["ACF Maclean"],"award-info":[{"award-number":["ACF Maclean"]}]},{"DOI":"10.13039\/501100000836","name":"University of Liverpool","doi-asserted-by":"publisher","award":["RS2"],"award-info":[{"award-number":["RS2"]}],"id":[{"id":"10.13039\/501100000836","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015909","name":"Liverpool Women's NHS Foundation Trust","doi-asserted-by":"publisher","award":["cancer charity"],"award-info":[{"award-number":["cancer charity"]}],"id":[{"id":"10.13039\/100015909","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Early diagnosis of the rare and life-threatening uterine leiomyosarcoma (LMS) is essential for prompt treatment, to improve survival. Preoperative distinction of LMS from benign leiomyoma remains a challenge, and thus LMS is often diagnosed post-operatively. This retrospective observational study evaluated the predictive diagnostic utility of 32 preoperative variables in 190 women who underwent a hysterectomy, with a postoperative diagnosis of leiomyoma (n = 159) or LMS (n = 31), at the Liverpool Women\u2019s National Health Service (NHS) Foundation Trust, between 2010 and 2019. A total of 7 preoperative variables were associated with increased odds of LMS, including postmenopausal status (p &lt; 0.001, OR 3.08), symptoms of pressure (p = 0.002, OR 2.7), postmenopausal bleeding (p = 0.001, OR 5.01), neutrophil count \u22657.5 \u00d7 109\/L (p &lt; 0.001, OR 5.72), haemoglobin level &lt;118 g\/L (p = 0.037, OR 2.22), endometrial biopsy results of cellular atypia or neoplasia (p = 0.001, OR 9.6), and a mass size of \u226510 cm on radiological imaging (p &lt; 0.0001, OR 8.52). This study has identified readily available and easily identifiable preoperative clinical variables that can be implemented into clinical practice to discern those with high risk of LMS, for further specialist investigations in women presenting with symptoms of leiomyoma.<\/jats:p>","DOI":"10.3390\/diagnostics10100735","type":"journal-article","created":{"date-parts":[[2020,9,23]],"date-time":"2020-09-23T09:28:08Z","timestamp":1600853288000},"page":"735","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Developing a Preoperative Algorithm for the Diagnosis of Uterine Leiomyosarcoma"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4365-9473","authenticated-orcid":false,"given":"Hannah","family":"Lawlor","sequence":"first","affiliation":[{"name":"Department of Women\u2019s and Children\u2019s Health, Institute of Life Course and Medical Sciences, University of Liverpool Member of Liverpool Health Partners, Liverpool L8 7SS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1505-3223","authenticated-orcid":false,"given":"Alexandra","family":"Ward","sequence":"additional","affiliation":[{"name":"Department of Women\u2019s and Children\u2019s Health, Institute of Life Course and Medical Sciences, University of Liverpool Member of Liverpool Health Partners, Liverpool L8 7SS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5713-6959","authenticated-orcid":false,"given":"Alison","family":"Maclean","sequence":"additional","affiliation":[{"name":"Department of Women\u2019s and Children\u2019s Health, Institute of Life Course and Medical Sciences, University of Liverpool Member of Liverpool Health Partners, Liverpool L8 7SS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Lane","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Liverpool Member of Liverpool Health Partners, Liverpool L69 3BX, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meera","family":"Adishesh","sequence":"additional","affiliation":[{"name":"Department of Women\u2019s and Children\u2019s Health, Institute of Life Course and Medical Sciences, University of Liverpool Member of Liverpool Health Partners, Liverpool L8 7SS, UK"},{"name":"Liverpool Women\u2019s NHS Foundation Trust Member of Liverpool Health Partners, Liverpool L8 7SS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sian","family":"Taylor","sequence":"additional","affiliation":[{"name":"Liverpool Women\u2019s NHS Foundation Trust Member of Liverpool Health Partners, Liverpool L8 7SS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shandya Bridget","family":"DeCruze","sequence":"additional","affiliation":[{"name":"Liverpool Women\u2019s NHS Foundation Trust Member of Liverpool Health Partners, Liverpool L8 7SS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dharani Kosala","family":"Hapangama","sequence":"additional","affiliation":[{"name":"Department of Women\u2019s and Children\u2019s Health, Institute of Life Course and Medical Sciences, University of Liverpool Member of Liverpool Health Partners, Liverpool L8 7SS, UK"},{"name":"Liverpool Women\u2019s NHS Foundation Trust Member of Liverpool Health Partners, Liverpool L8 7SS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,9,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1111\/aogs.12930","article-title":"Uterine leiomyosarcoma\u2014Incidence, treatment, and the impact of morcellation. 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