Authors reviewed retrospectively forty cases of the primary smooth muscle tumors arising from the digestive tract except mouth and pharynx, which were treated at the department of surgery of Presbyterian Medical Center, in Chonju, Korea, form
January,
1973 to May, 1991.
We evaluated the relationshiop between the clinical features and histopathologic findings, especially with the intent upon the prognostic value of histogic grade in the malignant tumor
@ES The following results were obtained;
@EN 1) There were 40 cases of smooth muscle tumors of digestive tract consist of 15 cases of leiomyoma and 25 cases of leiomyosarcoma.
2) The age of peak incidence was the fourth decade in leiomyoma and the fifth decade in leiomyosarcoma.
The male to female ratio was 1:15 in leiomyoma and 1.5:1 in leiomyosarcoma.
3) The primary sites of leiomyoma were stomach(11 cases0, small bowel(2 cases), large bowel and esophagus(each 1 case), and the primary sites of leiomvosarcoma were stomach(11 cases), small bowel(9cases), rectum(3 cases), large bowel(2 cases) in
order
of frequency.
4) The incidence of tumor under than 5 cm in size was 73% in leiomyoma, versus more than 5 cm was 84% in leiomyosarcoma.
5) the abdominal discomfort with pain each comprising of 53% in 15 leiomyoma cases, 44% in 25 leiomyosarcoma cases was the major symptom. As well as the abdominal discomfort with pain, abdominal mass(40%) and gastrointestinal bleeding(32%) were
the
important signs in leiomyosarcoma especially.
6) The preoperative diagnostic methods were UGIS, abdominal CT, and endoscopy with or without biopsy in stomach. The accuracies of diagnosis of gastric smooth muscle tumor in each method were 71% in abdominal CT. 65% in UGIS and 5% in endoscopic
biopsy.
7) The treatment modalities were Resection(8 cases), Enucleation(7 cases) in leiomyoma. Among them, Resection(80%) was the commonest procedure in the leiomyosarcoma.
8) The overall 5-year survival rate of leiomyosarcoma was 37%, but, comparing to the histologic grade of tumor, the overall 5-year survival rate was 71% in low grade and 11% in high grade.
9) The overall 5-year survival rates according to the stage were 100% in stage O(No unfavorable factors), 60% in stage I(One unfavorable factor) and 11% in stage II(Two unfavorable factors).
10) Nine cases of local recurrence and five cases of distant methastasis were occurrd in grade was 13%(1/8) in low grade and 67%(8/12) in high of leiomyosarcoma.
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