Leiomyosarcoma treatment in Israel

Leiomyosarcoma is a malignant tumor that originates from smooth muscle tissue. Most often, it is localized in the uterus, stomach, small intestine, peritoneum, around vascular bundles. It grows in the form of a nodular node, can affect the skin and bones. It has a very aggressive course and rapid growth rates, a high frequency of relapses and early metastasis.

In the treatment of leiomyosarcoma, the time factor is very important, that is, the sooner complex therapy is started, the higher the patient’s chances of survival. At Tel Aviv Medical Clinic, the diagnostic process takes only 3-4 days, all examinations can be done on site. Our specialists have extensive and successful experience in helping patients with leiomyosarcomas of various localizations.

We offer our patients:

• A completely individual approach to each clinical case of leiomyosarcoma. The treatment program is drawn up separately for each patient, taking into account all the characteristics of the person and his disease.
• Fast, comprehensive and modern diagnostics.
• Multidisciplinary approach. Assistance to one patient with leiomyosarcoma is provided not only by oncologists, but also by a whole team of professionals, depending on the characteristics of the clinical case.
• Opportunity to take part in clinical trials of new drugs, methods and treatment protocols absolutely free of charge.
• Rapid introduction into practice of the latest treatment methods and drugs.
• Use in the complex treatment of patients of the newest, most effective and safe drugs for polychemotherapy – Trabectin (“Yondelis”).
• Active use in treatment protocols of modern immunobiological agents and targeted drugs. For example, for patients with leiomyosarcoma, the following drugs are used: checkpoint inhibitors – Nivolumab, Ipilimumab.
• Effective organ-preserving minimally invasive surgical interventions.

Causes of leiomyosarcoma

Unfortunately, the true causes of leiomyosarcoma are unknown. But there are several factors that can increase the risk of tumor development:

• Age over 50 years. Uterine leiomyosarcoma is most often diagnosed in premenopausal and menopausal women.
• Negative effects of ionizing radiation (e.g., previous irradiation for another malignancy).
• Genetic predisposition, some genetic syndromes and diseases (e.g., carriers of the RB gene mutation in patients with retinoblastoma or Lynch syndrome).

Symptoms of leiomyosarcoma

Symptoms of leiomyosarcoma depend primarily on the location of the tumor.

Uterine leiomyosarcoma. The first symptoms are heavy menstruation, intermenstrual bleeding. The uterus is enlarged, the abdomen gradually increases in volume, ascites (fluid accumulation in the abdominal cavity) appears.

Vulvar leiomyosarcoma. A painful node develops in the soft tissue of the vulva, which may subsequently become covered with ulcers. Metastases appear quickly, especially often in the retroperitoneal lymph nodes.

Leiomyosarcoma of the scrotum. A lump appears in the soft tissues of the scrotum, the patient experiences a feeling of heaviness in the scrotum. As the tumor grows, an elastic node appears, which becomes covered with ulcers. As the disease progresses and metastases develop, back pain, swelling, impaired libido, and shortness of breath appear.

Leiomyosarcoma of the bladder. The first symptoms are difficulty urinating, blood and blood clots in the urine. Then pain in the lower abdomen occurs, and general symptoms of the disease join in.

Leiomyosarcoma of the gastrointestinal tract. Characteristic symptoms include nausea, vomiting, weight loss, constipation, belching, flatulence, abdominal pain, and blood in the stool.

Leiomyosarcoma of the retroperitoneal space. Symptoms are associated with compression of blood vessels. Ascites, lower limb edema, and inferior vena cava syndrome may develop.

Leiomyosarcoma of the skin. Nodules of different colors appear on the skin, which quickly grow deeper and become covered with ulcers. The tumor grows into all soft tissues and can even affect internal organs and bones.

General symptoms of the tumor appear in the later stages and include:

• lack of appetite and weight loss;
• anemia;
• nausea and vomiting;
• prolonged fever;
• general weakness;
• bleeding (e.g., gastrointestinal, uterine, etc.).

Modern diagnostic methods

In the case of leiomyosarcoma, as with other aggressive forms of malignant tumors, fast and accurate diagnostics are very important. The sooner the correct diagnosis is made, the higher the patient’s chances of recovery. At Tel Aviv Medical Clinic, specialists pay special attention to the diagnostic stage. All necessary examinations can be performed in one place in just 4-5 working days. At the same time, the diagnostic department is equipped with all the necessary modern expert-class diagnostic equipment, so diagnostics are not only accurate, but also safe.

The diagnostic program for suspected leiomyosarcoma includes:

• A set of necessary blood and urine tests.
• Modern medical imaging techniques – ultrasound, CT, MRI, MSCT, PET-CT, PET-MRI, osteoscintigraphy. They allow not only to visualize the tumor itself, determine its location, size, degree of spread to adjacent tissues, but also to identify all metastases, if any.
• Endoscopic methods of examining organs and body cavities – esophagogastroduodenoscopy, video capsule endoscopy, colonoscopy, cystoscopy, hysteroscopy, laparoscopy.
• Biopsy and subsequent pathohistological, molecular-genetic examination of tissue samples.
• Very often, patients come to Israel for treatment with a knowingly incorrect diagnosis. The fact is that pathohistological verification of sarcomas is a very difficult task. Very few specialists can correctly interpret tissue samples after a biopsy. Our patients’ samples are examined only by highly qualified pathologists with a world-famous name. Thanks to such diagnostics, we are absolutely sure of the diagnosis and the appointment of the appropriate treatment protocol.

Genetic diagnostics

Also, after a biopsy, TAMS patients undergo innovative molecular-genetic studies of tumor cells. This is necessary to identify their characteristics or search for “targets” for therapy. Subsequently, this information helps doctors select the most effective treatment protocol and modern immunobiological drugs (for example, targeted agents).

We send all materials after biopsy to the best genetic laboratories in the USA to verify the diagnosis and determine the genetic profile of tumor cells in order to identify types of genetic changes and select the most effective treatment, while the material is collected on site at TAMS.

Examples of modern genetic testing panels for patients with leiomyosarcomas:

• MCSRC | MayoComplete Comprehensive Sarcoma Panel, Next-Generation Sequencing.
• MCSMP | MayoComplete Sarcoma Mutation Panel, Next-Generation Sequencing, Tumor.
• SARCP | Sarcoma Targeted Gene Fusion/Rearrangement Panel, Next-Generation Sequencing, Tumor.
• LYNCP | Lynch Syndrome Panel, Varies.

The full list of molecular genetic tests that Tel Aviv Medical Clinic offers to its patients can be viewed here. All genetic tests are unique tests that can be performed at Tel Aviv Medical Clinic.

Prognosis for leiomyosarcoma

The prognosis for leiomyosarcoma depends on the stage of the disease, the location of the tumor, the presence of metastases, and the general health of the patients. At the initial stages, the 5-year survival rate of patients is 82%, with locally advanced forms – up to 59%, with metastases – up to 16%.

Thanks to the active use of a comprehensive treatment method by Tel Aviv Medical Clinic specialists, the introduction of the most modern therapy methods, and participation in clinical trials, it is possible to significantly increase the percentage of 5-year survival among patients with leiomyosarcomas.

Modern methods of treating leiomyosarcoma

The method of treating leiomyosarcoma depends on the location of the tumor, its size, spread, and stage of the disease. At Tel Aviv Medical Clinic, we use an individual approach to each patient. The treatment program is always comprehensive, including various combinations of surgical operations, radiation therapy, and chemotherapy.

All our patients can become participants in clinical trials of new drugs, treatment protocols, and innovative methods. Our specialists actively participate in such experiments, and they also constantly improve and refine standard treatment protocols for various oncological diseases. If the patient meets the necessary parameters (we will be able to give an answer after studying all your medical documents), he can become a participant in such an experimental program and try closed protocols (developed within the clinic) as an alternative treatment. Often, this is the only chance for the patient to overcome a serious disease, especially in situations where standard treatment protocols have proven ineffective.

Surgical treatment of leiomyosarcoma is considered the main method. Only with the help of surgery can the tumor be completely removed. Basically, all operations can be performed using minimally invasive techniques – laparoscopy and hysteroscopy for uterine leiomyosarcoma. Open surgery with removal of the uterus is resorted to only in extreme cases.

Innovative surgical methods for treating leiomyosarcoma are available to our patients:

• Robotic surgery using the Da Vinci installation.
• Robotic surgery using the Single Port installation.
• Single-port videothoracoscopy in oncogynecology.
• Surgical cytoreduction in combination with chemotherapy.

Chemotherapy is usually performed in the second stage of treatment after radical surgery. The main goal of chemotherapy is to combat metastases and destroy all malignant cells to prevent relapse of the disease. As a rule, the following drugs are used to treat leiomyosarcoma: doxorubicin + ifosfamide, gemcitabine + docetaxel. The innovative chemotherapy drug trabectedin was introduced into leiomyosarcoma treatment protocols in 2024. It is prescribed to patients who have already undergone chemotherapy, but without much success. As studies show, trabectedin is 3 times more effective than standard polychemotherapy regimens.

Radiation therapy for leiomyosarcoma is indicated when surgical intervention is impossible (in the late stages of cancer) to control symptoms and the course of the disease, as well as in the postoperative period to prevent relapses. The radiation oncologists of our clinic use modern types of radiotherapy, in particular, intensity-controlled radiation therapy (IMRT). This method of cancer treatment involves a pinpoint effect on the tumor and preservation of healthy organs and tissues. The duration and volume of radiation using the IMRT method are significantly less than with standard radiotherapy.

Treatment of cancer at late stages, according to modern protocols, involves the use of targeted therapy, as well as other types of immunotherapies. Tel Aviv Medical Clinic doctors use the latest biopreparations. They have a direct effect on malignant tumor cells, stopping their growth and division. Healthy tissues are not affected, which distinguishes fundamentally targeted therapy from classical chemotherapy. Examples of targeted drugs for the treatment of leiomyosarcoma are Nivolumab, Ipilimumab.

In each individual case, the decision on the combination of certain treatment methods is made jointly by a team of specialists. Each patient and their disease are different, so our doctors, relying on their experience in treating oncological pathologies, often go beyond standard protocols, changing treatment regimens and doses of necessary drugs, radiation techniques in order to achieve the best results for their patients.

If you or a loved one has been diagnosed with leiomyosarcoma, don’t wait—early treatment is crucial. Contact Tel Aviv Medical Clinic today to discuss your personalized treatment plan with our expert oncologists.