Recent studies have explored various treatment strategies for leiomyosarcoma (LMS), focusing on novel drug combinations and surgical interventions. A phase I study evaluated the combination of pexidartinib, a colony-stimulating factor-1 receptor inhibitor, and sirolimus, an mTOR inhibitor, in targeting tumor-associated macrophages in patients with unresectable sarcomas, including LMS. The study enrolled 24 patients and utilized a time-to-event continual reassessment method to assess safety and tolerability, demonstrating a promising approach to modifying the tumor microenvironment (ref: Manji doi.org/10.1158/1078-0432.CCR-21-1779/). Additionally, a multicenter phase II trial investigated the efficacy of doxorubicin combined with trabectedin as first-line therapy for locally advanced or metastatic LMS. With a median follow-up of 7.2 years, the study reported a median progression-free survival (PFS) of 10.1 months and overall survival (OS) of 34.4 months, confirming the effectiveness of this combination therapy (ref: Pautier doi.org/10.1016/j.esmoop.2021.100209/). Furthermore, surgical strategies such as radical hemiscrotectomy and en bloc orchidectomy were explored, revealing their role in managing inguinoscrotal cancers, including LMS, with a cohort of 16 patients demonstrating varied oncological outcomes (ref: Fankhauser doi.org/10.1245/s10434-021-10315-4/).

Accurate preoperative diagnosis of leiomyosarcoma (LMS) is crucial for effective treatment planning. A study on endometrial sampling highlighted its effectiveness in preoperative detection of uterine LMS, showing a threefold improvement in diagnosis accuracy when hysteroscopy was employed (ref: Kho doi.org/10.1016/j.jmig.2021.07.004/). Another investigation assessed preoperative blood inflammatory markers to differentiate between uterine LMS and leiomyoma, analyzing clinical and laboratory variables from 336 patients. The findings indicated significant differences in inflammatory markers that could aid in preoperative differentiation (ref: Suh doi.org/10.2147/CMAR.S314219/). Additionally, a case series of 50 patients evaluated MRI characteristics to distinguish between various types of uterine sarcomas, identifying specific radiological features that correlated with histopathological diagnoses, thus enhancing diagnostic accuracy (ref: Hélage doi.org/10.1155/2021/). These studies collectively emphasize the importance of integrating advanced diagnostic techniques to improve the identification and management of LMS.

Surgical interventions play a pivotal role in the management of leiomyosarcoma (LMS), with various studies highlighting the outcomes of different surgical techniques. A retrospective cohort study examined radical hemiscrotectomy and en bloc orchidectomy in 16 patients, revealing that these procedures can be effective for managing inguinoscrotal cancers, including LMS (ref: Fankhauser doi.org/10.1245/s10434-021-10315-4/). Another multicenter study focused on surgical resection and graft replacement for primary inferior vena cava (IVC) leiomyosarcoma, emphasizing the necessity of surgical intervention when feasible. The study aimed to evaluate the most effective reconstruction methods post-resection, contributing valuable data to the surgical management of IVC LMS (ref: Nooromid doi.org/10.1016/j.jvsv.2021.06.021/). Furthermore, a study on reoperation with total hysterectomy after incomplete surgery in patients with incidentally diagnosed uterine LMS demonstrated that re-exploration significantly improved disease-free survival (DFS) and overall survival (OS), underscoring the importance of thorough surgical management in improving patient outcomes (ref: Zhang doi.org/10.1159/000515895/).

The genomic and pathological characterization of leiomyosarcoma (LMS) has gained attention, particularly in understanding the molecular underpinnings of the disease. A study focused on BCORL1-driven high-grade endometrial stromal sarcomas, revealing that BCORL1 alterations are prevalent in a subset of uterine sarcomas, with significant implications for diagnosis and treatment (ref: Lin doi.org/10.1038/s41379-021-00873-z/). This study identified various genomic alterations, including rearrangements and mutations, in 12 cases, highlighting the need for genomic profiling in sarcoma management. Additionally, a multi-institutional validation study assessed prognostic nomograms for retroperitoneal sarcoma, validating tools like the Sarculator and MSK nomograms in predicting outcomes for patients undergoing resection (ref: Squires doi.org/10.1002/jso.26586/). The findings from these studies emphasize the importance of integrating genomic data into clinical practice to enhance prognostic accuracy and tailor treatment strategies for LMS patients.

Identifying prognostic factors in leiomyosarcoma (LMS) is essential for improving patient management and outcomes. A multi-institutional study validated prognostic nomograms for retroperitoneal sarcoma, demonstrating their utility in predicting survival outcomes for patients undergoing surgical resection. The study analyzed data from 502 patients, providing a robust framework for assessing prognosis based on clinical and pathological variables (ref: Squires doi.org/10.1002/jso.26586/). Additionally, research on preoperative blood inflammatory markers aimed to differentiate between uterine LMS and leiomyoma, revealing significant intergroup differences that could serve as potential prognostic indicators (ref: Suh doi.org/10.2147/CMAR.S314219/). These studies collectively highlight the importance of integrating clinical, pathological, and genomic factors to refine prognostic assessments and guide treatment decisions in LMS.