We reviewed 29 patients with malignant gastric leiomyoma seen at four hospitals, Catholic University Medical College between 1981 and 1990 retrospectively, and these patients were studies in an attempt to delineate clinical and pathological
features of
the disease and to analyses factors influencing on survival post-operatively.
The 29 patients represents 0.85% of all patietns with gastric cancers, 3,395 patients, presenting during the same period. The age range in our series was 20 to 76, with a median age of 58. The patiets between the sixth and seventh decade of age
were
62.1%, Of the 29 patients 10 were men and 19 were women, the male to female ratio being 1 : 1.9. The most frequent clinical manifestations were those of upper gastrointestinal bleeding, as hematemesis and melena, epigastric pain, and epigastric
palpable
mass. Studies yielding the most frequent postive findings were upper gastrointestinal series, gastrointestinal, and CAT scanning.
We calculated the cumulative survival rate according to the Kaplan-meier's product-limit method and analysed statistical differences by the Student's t test. Sex did not show any statistical influence on the survival rate of these patients. The
histopathological grade of malignancy appeared to have had an important influence on survival. 72.8% of the patients who had low-grade tumors survived six or more years, in contrast to no survivor with high-grade tumors after 8 years
post-operatively.
Tumor size did not significantly influence on the survival rate, although the patients with smaller size(less than 5 cm) of low-grade tumors survived linger. Although the extent ad mode of surgical invasion of adjacent organs, the best survival
rates
were observed in the patients receiving distal partial gastrectomy with statistical difference.
As the result in our series, we observed that the histopathological grade of malignancy, the size of the tumor especially depending on its grade, and the extent and mode of surgery showed significant prognostic influence after surgical
intervention
on
malignant gastric leiomyoma.
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