Comparison of neoadjuvant cisplatin-based chemotherapy versus radiochemotherapy followed by resection for stage III (N2) NSCLC.

OBJECTIVE: Comparison of prospectively treated patients with neoadjuvant cisplatin-based chemotherapy vs radiochemotherapy followed by resection for mediastinoscopically proven stage III N2 non-small cell lung cancer with respect to postoperative morbidity, pathological nodal downstaging, overall and disease-free survival, and site of recurrence. METHODS: Eighty-two patients were enrolled between January 1994 to June 2003, 36 had cisplatin and doxetacel-based chemotherapy (group I) and 46 cisplatin-based radiochemotherapy up to 44 Gy (group II), either as sequential (25 patients) or concomitant (21 patients) treatment. All patients had evaluation of absence of distant metastases by bone scintigraphy, thoracoabdominal CT scan or PET scan, and brain MRI, and all underwent pre-induction mediastinoscopy, resection and mediastinal lymph node dissection by the same surgeon. RESULTS: Group I and II comprised T1/2 tumors in 47 and 28%, T3 tumors in 45 and 41%, and T4 tumors in 8 and 31% of the patients, respectively (P=0.03). There was a similar distribution of the extent of resection (lobectomy, sleeve lobectomy, left and right pneumonectomy) in both groups (P=0.9). Group I and II revealed a postoperative 90-d mortality of 3 and 4% (P=0.6), a R0-resection rate of 92 and 94% (P=0.9), and a pathological mediastinal downstaging in 61 and 78% of the patients (P<0.01), respectively. 5y-overall survival and disease-free survival of all patients were 40 and 36%, respectively, without significant difference between T1-3 and T4 tumors. There was no significant difference in overall survival rate in either induction regimens, however, radiochemotherapy was associated with a longer disease-free survival than chemotherapy (P=0.04). There was no significant difference between concurrent vs sequential radiochemotherapy with respect to postoperative morbidity, resectability, pathological nodal downstaging, survival and disease-free survival. CONCLUSIONS: Neoadjuvant cisplatin-based radiochemotherapy was associated with a similar postoperative mortality, an increased pathological nodal downstaging and a better disease-free survival as compared to cisplatin doxetacel-based chemotherapy in patients with stage III (N2) NSCLC although a higher number of T4 tumors were admitted to radiochemotherapy.

The magmatic to hydrothermal evolution of the intrusive Mont Saint-Hilaire Complex: Insights into the late-stage evolution of peralkaline rocks

The Cretaceous Mont Saint-Hilaire complex (Quebec, Canada) comprises three major rock units that were emplaced in the following sequence: (I) gabbros; (II) diorites; (III) diverse partly agpaitic foid syenites. The major element compositions of the rock-forming minerals, age-corrected Nd and oxygen isotope data for mineral separates and trace element data of Fe-Mg silicates from the various lithologies imply a common source for all units. The distribution of the rare earth elements in clinopyroxene from the gabbros indicates an ocean island basalt type composition for the parental magma. Gabbros record temperatures of 1200 to 800 degrees C, variable silica activities between 0 center dot 7 and 0 center dot 3, and f(O2) values between -0 center dot 5 and +0 center dot 7 (log delta FMQ, where FMQ is fayalite-magnetite-quartz). The diorites crystallized under uniform a(SiO2) (a(SiO2) = 0 center dot 4-0 center dot 5) and more reduced f(O2) conditions (log delta FMQ similar to-1) between similar to 1100 and similar to 800 degrees C. Phase equilibria in various foid syenites indicate that silica activities decrease from 0 center dot 6-0 center dot 3 at similar to 1000 degrees C to < 0 center dot 3 at similar to 550 degrees C. Release of an aqueous fluid during the transition to the hydrothermal stage caused a(SiO2) to drop to very low values, which results from reduced SiO(2) solubilities in aqueous fluids compared with silicate melts. During the hydrothermal stage, high water activities stabilized zeolite-group minerals. Fluid inclusions record a complex post-magmatic history, which includes trapping of an aqueous fluid that unmixed from the restitic foid syenitic magma. Cogenetic aqueous and carbonic fluid inclusions reflect heterogeneous trapping of coexisting immiscible external fluids in the latest evolutionary stage. The O and C isotope characteristics of fluid-inclusion hosted CO(2) and late-stage carbonates imply that the surrounding limestones were the source of the external fluids. The mineral-rich syenitic rocks at Mont Saint-Hilaire evolved as follows: first, alkalis, high field strength and large ion lithophile elements were pre-enriched in the (late) magmatic and subsequent hydrothermal stages; second, percolation of external fluids in equilibrium with the carbonate host-rocks and mixing processes with internal fluids as well as fluid-rock interaction governed dissolution of pre-existing minerals, element transport and precipitation of mineral assemblages determined by locally variable parameters. It is this hydrothermal interplay between internal and external fluids that is responsible for the mineral wealth found at Mont Saint-Hilaire.

Early Stage Primary Bone Lymphoma: A Retrospective, Multicenter Rare Cancer Network Study

Purpose/Objective(s): Primary bone lymphoma (PBL) represents less than 1% of all malignant lymphomas, and 4-5% of all extranodal lymphomas. In this study, we assessed the disease profile, outcome, and prognostic factors in patients with stage I and II PBL.Materials/Methods: Between 1987 and 2008, 116 consecutive patients with PBL treated in 13 RCNinstitutions were included in this study. Inclusion criteriawere: age.17 yrs, PBLin stage I and II, andminimum6months follow-up. The median agewas 51 yrs (range: 17-93).Diagnosticwork-up included plain boneXray (74%of patients), scintigraphy (62%), CT-scan (65%),MRI (58%), PET (18%), and bone-marrow biopsy (84%).All patients had biopsy-proven confirmation of non-Hodgkin's lymphoma (NHL). The histopathological type was predominantly diffuse large B-cell lymphoma (78%) and follicular lymphoma (6%), according to theWHOclassification. One hundred patients had a high-grade, 7 intermediate and 9 low-gradeNHL. Ninety-three patients had anAnn-Arbor stage I, and 23 had a stage II. Seventy-seven patients underwent chemoradiotherapy (CXRT), 12 radiotherapy (RT) alone, 10 chemotherapy alone (CXT), 9 surgery followed by CXRT, 5 surgery followed by CXT, and 2 surgery followed by RT. One patient died before treatment.Median RT dosewas 40Gy (range: 4-60).Themedian number ofCXTcycleswas 6 (range, : 2-8).Median follow-upwas 41months (range: 6-242).Results: Following treatment, the overall response rate was 91% (CR 74%, PR 17%). Local recurrence was observed in 12 (10%) patients, and systemic recurrence in 17 (15%) patients. Causes of death included disease progression in 16, unrelated disease in 6, CXT-related toxicity in 1, and secondary cancer in 2 patients. The 5-yr overall survival (OS), disease-free survival (DFS), lymphoma- specific survival (LSS), and local control (LC) were 76%, 69%, 78%, and 92%, respectively. In univariate analyses (log-rank test), favorable prognostic factors for survival were: age\50 years (p = 0.008), IPI score #1 (p = 0.009), complete response (p\0.001), CXT (p = 0.008), number of CXT cycles $6 (p = 0.007), and RT dose . 40 Gy (p = 0.005). In multivariate analysis age, RT dose, complete response, and absence of B symptoms were independent factors influencing the outcome. There were 3 patients developing grade 3 or more (CTCAE.V3.0) toxicities.Conclusions: This large multicenter study, confirms the relatively good prognosis of early stage PBL, treated with combined CXRT. Local control was excellent, and systemic failure occurred infrequently. A sufficient dose of RT (. 40 Gy) and completeCXT regime (. 6 cycles) were associated with a better outcome. Combined modality appears to be the treatment of choice.Author Disclosure: L. Cai, None; M.C. Stauder, None; Y.J. Zhang, None; P. Poortmans, None; Y.X. Li, None; N. Constantinou, None; J. Thariat, None; S. Kadish, None; M. Ozsahin, None; R.O. Mirimanoff, None.

Recent misconceptions about the "database search problem": a probabilistic analysis using Bayesian networks

This paper analyses and discusses arguments that emerge from a recent discussion about the proper assessment of the evidential value of correspondences observed between the characteristics of a crime stain and those of a sample from a suspect when (i) this latter individual is found as a result of a database search and (ii) remaining database members are excluded as potential sources (because of different analytical characteristics). Using a graphical probability approach (i.e., Bayesian networks), the paper here intends to clarify that there is no need to (i) introduce a correction factor equal to the size of the searched database (i.e., to reduce a likelihood ratio), nor to (ii) adopt a propositional level not directly related to the suspect matching the crime stain (i.e., a proposition of the kind 'some person in (outside) the database is the source of the crime stain' rather than 'the suspect (some other person) is the source of the crime stain'). The present research thus confirms existing literature on the topic that has repeatedly demonstrated that the latter two requirements (i) and (ii) should not be a cause of concern.

Biologicals and fetal cell therapy for wound and scar management.

Few biopharmaceutical preparations developed from biologicals are available for tissue regeneration and scar management. When developing biological treatments with cellular therapy, selection of cell types and establishment of consistent cell banks are crucial steps in whole-cell bioprocessing. Various cell types have been used in treatment of wounds to reduce scar to date including autolog and allogenic skin cells, platelets, placenta, and amniotic extracts. Experience with fetal cells show that they may provide an interesting cell choice due to facility of outscaling and known properties for wound healing without scar. Differential gene profiling has helped to point to potential indicators of repair which include cell adhesion, extracellular matrix, cytokines, growth factors, and development. Safety has been evidenced in Phase I and II clinical fetal cell use for burn and wound treatments with different cell delivery systems. We present herein that fetal cells present technical and therapeutic advantages compared to other cell types for effective cell-based therapy for wound and scar management.

Relatório de Estimativa da Produção Agro - Pecuário - 2013

Este relatório apresenta a estimativa da produção agropecuária relativamente ao ano 2013. São apresentadas as estimativas de produção de (i) Hortícolas; (ii) Raízes e Tubérculos; (iii) Frutas; (iv) Culturas de Renda; (v) Culturas de Sequeiro; (vi) Produtos Pecuários; e (vii) Produtos Silvícolas. Tem havido grande aumento na produção de hortícolas ao longo dos últimos anos graças às tecnologias mais produtivas, introduzidas na horticultura, nomeadamente: a adopção massiva de novas tecnologias de rega, a ampla utilização de sementes híbridas, o aumento do número de estufas e sistemas hidropónicos instalados, entre outras. Estas tecnologias, conjuntamente com o aumento na disponibilidade de água, têm contribuído para o aumento da produção e para o abastecimento do mercado de forma mais regular, com produtos mais diversificados e de maior qualidade. As estimativas de produção referentes aos últimos 5 anos apontam para uma média à volta de 47.000 toneladas de hortícolas produzidas anualmente, sendo a produção de 2013 estimada em 51.265 toneladas, correspondendo a um aumento de 5% relativamente à produção estimada para 2012. A produção de raízes e tubérculos tem também aumentado consideravelmente. A produção de 2013 é estimada em 27.163 toneladas, equivalente a um aumento de cerca de 25% relativamente ao ano anterior. Refira-se que a importação de raízes e tubérculos nos últimos 5 anos, que se restringe quase que exclusivamente à batata comum, tem registado uma tendência decrescente. Segundo os dados divulgados pelo INE, de 2009 a 2013 a importação de batata comum (fresca) desceu de 9.032 toneladas, em 2009, para 5.238 toneladas, em 2013, ou seja uma diminuição de 42%. Outro dado digno de destaque é a descida contínua no preço médio anual tanto da mandioca como da batata-doce, no mercado nacional, nos últimos 5 anos, embora este último tenha aumentado ligeiramente em 2013.A produção de frutas em 2013 foi estimada à volta de 17.000 toneladas, correspondendo a um aumento de cerca de 4% em relação ao ano precedente. A introdução das culturas de banana “in vitro” a partir de 2009, a introdução de novas tecnologias de rega, novas variedades de papaia e manga bem como o aumento da área cultivada destas frutas em pomar, e o número de plantas fixadas de outras espécies fruteiras, apontam para um acréscimo significativo da produção frutícola nos últimos anos. As intervenções levadas a cabo neste subsector ao longo dos anos têm sido refletidas claramente nas quantidades disponíveis no mercado bem como na baixa dos preços que se tem verificado, principalmente no que diz respeito à banana e à papaia, embora esta última tenha registado uma ligeira subida no preço médio em 2013 (1,27%). Não se faz importação de banana desde 2009, inclusive; a importação de papaia, embora apresentando algumas oscilações, baixou consideravelmente no período 2009 a 2011, voltando porém a subir em 2012 e novamente em 2013, de forma acentuada; a importação de manga também apresenta flutuações, tendo aumentado em 2012 e em 2013. Contudo, as quantidades importadas de papaia e manga são muito reduzidas (48 toneladas e 44 toneladas, respetivamente, em 2013), representando apenas uma ínfima percentagem da oferta total destas frutas ao nível nacional (apenas 1,4% e 2%, respectivamente). Dos contactos que a DSEGI fez as empresas importadoras de manga e papaia obtivemos informação que as mesmas, estão localizadas nas ilhas do Sal e da Boa Vista e, que a quantidade importada se justifica pelo facto, de não existir uma rede de transportes permanente, capaz de dar resposta as necessidades das ilhas turísticas, no que respeita ao escoamento dos produtos, das ilhas de maior produção para as de fraca produção. Entretanto, graças às melhorias registadas na produção hortofrutícola, tem-se verificado que a produção nacional vem conquistando paulatinamente o mercado turístico, tendo as vendas aos hotéis aumentado cerca de dez vezes mais, no período de 2010 a 2013, passando de 57 toneladas para 608 toneladas. Outros produtos como ovos e queijos vêm igualmente conquistando esse mercado, não obstante os problemas de transporte inter-ilhas que continuam constituindo um entrave no escoamento dos produtos agrícolas entre as ilhas. No que toca às culturas de renda, as estimativas da produção anual de uvas apontam para sucessivos aumentos, tendo atingido 346 toneladas em 2013, na maioria destinada à produção de vinhos. A produção de café sofreu uma diminuição em 2013, à volta de 30%, relacionada com a problemática da safra/contrassafra. A produção estimada de cana-de-açúcar manteve-se estável em 28.375 toneladas. Os produtos tradicionais de sequeiro, milho e feijões, dependentes da aleatoriedade das chuvas, sofreram um ligeiro decréscimo em 3013, respetivamente 3,6% e 0,1%. Os produtos pecuários cujas estimativas de produção baseiam-se em dados que carecem de atualização (dados sobre o número de efectivos que remontam ao RGA 2004, e coeficientes zootécnicos provenientes do Plano Director da Pecuária), apresentam ligeiros aumentos na produção estimada para 2013, com excepção da produção de ovos em que os dados fornecidos pelos produtores indicam uma ligeira diminuição à volta de 3% (alguns produtores justificam a diminuição da produção pela falta de transportes inter-ilhas). A seguir se apresenta um resumo dos resultados da estimativa de produção 2013.

Mycorrhizal ecology and evolution: the past, the present, and the future.

1406 I. 1407 II. 1408 III. 1410 IV. 1411 V. 1413 VI. 1416 VII. 1418 1418 References 1419 SUMMARY: Almost all land plants form symbiotic associations with mycorrhizal fungi. These below-ground fungi play a key role in terrestrial ecosystems as they regulate nutrient and carbon cycles, and influence soil structure and ecosystem multifunctionality. Up to 80% of plant N and P is provided by mycorrhizal fungi and many plant species depend on these symbionts for growth and survival. Estimates suggest that there are c. 50 000 fungal species that form mycorrhizal associations with c. 250 000 plant species. The development of high-throughput molecular tools has helped us to better understand the biology, evolution, and biodiversity of mycorrhizal associations. Nuclear genome assemblies and gene annotations of 33 mycorrhizal fungal species are now available providing fascinating opportunities to deepen our understanding of the mycorrhizal lifestyle, the metabolic capabilities of these plant symbionts, the molecular dialogue between symbionts, and evolutionary adaptations across a range of mycorrhizal associations. Large-scale molecular surveys have provided novel insights into the diversity, spatial and temporal dynamics of mycorrhizal fungal communities. At the ecological level, network theory makes it possible to analyze interactions between plant-fungal partners as complex underground multi-species networks. Our analysis suggests that nestedness, modularity and specificity of mycorrhizal networks vary and depend on mycorrhizal type. Mechanistic models explaining partner choice, resource exchange, and coevolution in mycorrhizal associations have been developed and are being tested. This review ends with major frontiers for further research.

A secreted high-affinity inhibitor of human TNF from Tanapox virus.

A class of secreted poxvirus tumor necrosis factor (TNF)-binding proteins has been isolated from Tanapox-infected cell supernatants. The inhibitor bound to a TNF-affinity column and was identified as the product of the 2L gene. Sequence analysis of 2L family members from other yatapoxviruses and swinepox virus yielded no sequence homology to any known cellular gene. The expressed Tanapox virus 2L protein bound to human TNF with high affinity (K(d) = 43 pM) and exhibits an unusually slow off-rate. However, 2L is unable to bind to a wide range of human TNF family members. The 2L protein can inhibit human TNF from binding to TNF receptors I and II as well as block TNF-induced cytolysis. Thus, Tanapox virus 2L represents an inhibitor of human TNF and offers a unique strategy with which to modulate TNF activity.

Quantitative Assessment of T1 Relaxation and Diffusion as a Prognostic Tool for Brain Development: A Longitudinal Preliminary Study on Preterm Babies

BACKGROUND: Despite major advances in care of premature infants, survivors exhibit mild cognitive deficits in around 40%. Beside severe intraventricular haemorrhages (IVH) and cystic periventricular leucomalacia (PVL), more subtle patterns such as grade I and II IVH, punctuate WM lesions and diffuse PVL might be linked to the cognitive deficits. Grey matter disease is also recognized to contribute to long-term cognitive impairment.¦OBJECTIVE: We intend to use novel MR techniques to study more precisely the different injury patterns. In particular MP2RAGE (magnetization prepared dual rapid echo gradient) produces high-resolution quantitative T1 relaxation maps. This contrast is known to reflect tissue anomalies such as white matter injury in general and dysmyelination in particular. We also used diffusion tensor imaging, a quantitative technique known to reflect white matter maturation and disease.¦DESIGN/METHODS: All preterm infants born under 30 weeks of GA were included. Serial 3T MR-imaging using a neonatal head-coil at DOL 3, 10 and at term equivalent age (TEA), using DTI and MP2RAGE sequences was performed. MP2RAGE generates a T1 map and allows calculating the relaxation time T1. Multiple measurements were performed for each exam in 12 defined white and grey matter ROIs.¦RESULTS: 16 patients were recruited: mean GA 27 2/7 w (191,2d SD±10,8), mean BW 999g (SD±265). 39 MRIs were realized (12 early: mean 4,83d±1,75, 13 late: mean 18,77d±8,05 and 14 at TEA: 88,91d±8,96). Measures of relaxation time T1 show a gradual and significant decrease over time (for ROI PLIC mean±SD in ms: 2100.53±102,75, 2116,5±41,55 and 1726,42±51,31 and for ROI central WM: 2302,25±79,02, 2315,02±115,02 and 1992,7±96,37 for early, late and TEA MR respectively). These trends are also observed in grey matter area, especially in thalamus. Measurements of ADC values show similar monotonous decrease over time.¦CONCLUSIONS: From these preliminary results, we conclude that quantitative MR imaging in very preterm infants is feasible. On the successive MP2RAGE and DTI sequences, we observe a gradual decrease over time in the described ROIs, representing the progressive maturation of the WM micro-structure and interestingly the same evolution is observed in the grey matter. We speculate that our study will provide normative values for T1map and ADC and might be a predictive factor for favourable or less favourable outcome.

La prothèse de St Jude medical chez les patients âges de plus de 65 ans [St Jude's Medical prosthesis in patients over 65].

Between September 1979 and December 1982, 56 St Jude Medical valvular prostheses were implanted in 54 patients over 65 years of age. Surgery consisted in simple aortic valve replacement (35 cases), simple mitral valve replacement (12 cases), double aortic and mitral valve replacement (2 cases), valve replacement and coronary artery bypass surgery (3 cases), aortic valve replacement and replacement of the ascending aorta (1 case) and mitral valve replacement and tricuspid annuloplasty (1 case). The operative mortality (within 30 days of surgery) was 3.5% (2 cases). Patients were assessed by clinical examination, ECG, chest X-ray, echocardiogram and laboratory investigations on average 19 months after surgery. There were 3 late deaths (1 endocarditis, 1 cardiac failure and 1 subdural haematoma). No cases of significant haemolysis were observed. There were no cases of thrombosis of the valve or any deaths directly related to the valve. Four patients had cerebral embolism (4.9% per patient/year). None were fatal and only 1 patient had sequellae. Clinical improvement was very significant; 96% of the patients are now in the NYHA Classes I and II whilst 80% were in Class III or IV before surgery. The cardiothoracic ratio decreased significantly from 0.56 to 0.51 (p less than 0.01). The authors conclude that elderly patients may derive great benefits from valvular cardiac surgery and that age in itself is not a contraindication to this type of surgery. The St Jude Medical prosthesis is an excellent prosthesis but thromboembolism remains a major problem as with other mechanical prostheses. Anticoagulation for life is essential.

Madurez gonadal de algunos peces de importancia comercial: escalas macroscópicas validadas microscópicamente

Describen las escalas de madurez gonadal macroscópicas, validadas mediante análisis microscópicos, de diez especies de peces: Engraulis ringens anchoveta peruana, Merluccius gayi peruanus merluza, Sarda chiliensis chiliensis bonito, Scomber japonicus peruanus caballa, Anchoa nasus anchoveta blanca, Paralabrax humeralis cabrilla, Paralichthys adspersus lenguado, Cynoscion analis cachema, Hippoglossina macrops lenguado de ojo grande y Vinciguerria lucetia. Todas las escalas tienen seis estadios de madurez para hembras y machos: 0 (virginal), I (reposo), II (en maduración), III (maduro), IV (desovante/expulsante), V (recuperación/post expulsante). Se describen características y criterios claros para diferenciación entre estadios de madurez por especie y se discute la importancia de la validación y sus múltiples aplicaciones

Escala de madurez gonadal de anchoveta peruana Engraulis ringens (Jenyns, 1842

En este trabajo, se describe la escala de madurez gonadal macroscópica, validada microscópicamente, de anchoveta peruana Engraulis ringens. Se analizó 1970 gónadas (1251 ovarios, 719 testículos), procedentes del seguimiento de la pesquería pelágica del 2006, 2008, 2009 y 2012 y de cruceros de Evaluación Hidroacústica de Recursos Pelágicos del 2006, 2009 y 2012. La escala establece seis estadios de madurez para hembras y machos: 0 (virginal), I (reposo), II (en maduración), III (maduro), IV (desovante/expulsante), V (recuperación/post expulsante).

Escala de madurez gonadal de merluza peruana Merluccius gayi peruanus (Ginsburg, 1954)

Se determinó la escala de madurez gonadal macroscópica, validada microscópicamente del recurso merluza peruana Merluccius gayi peruanus. Para ello, se analizaron histológicamente gónadas de hembras y machos colectadas en los cruceros de Evaluación de Recursos Demersales, desde el otoño del 2002 hasta el verano del 2004. En base a las observaciones microscópicas de cada estadio de madurez gonadal, se establecen las características visuales más conspicuas que diferencian a cada uno de ellos, estableciéndose seis estadios tanto para hembras como para machos: 0 (virginal), I (reposo), II (en maduración), III (maduro), IV (desovante/expulsante), V (recuperación/ post expulsante).

Escala de madurez gonadal de hembras de lenguado de ojo grande Hippoglossina macrops (Steindachner, 1876)

El lenguado de ojo grande Hippoglossina macrops es un recurso potencial poco estudiado. Tiene una amplia distribución latitudinal (3°S-8°S) y batimétrica (90-380 m de profundidad). Para determinar la escala de madurez gonadal, se analizaron 570 ovarios colectados en los Cruceros de Evaluación de Recursos Demersales de los años 2003 al 2007. Se determinó seis estadios de madurez gonadal: 0 (virginal), I (reposo), II (en maduración), III (maduro), IV (desovante), V (recuperación), los que permiten conocer con mayor certeza, la condición reproductiva de las hembras de esta especie y su principal periodo de reproducción.

Prognostic factors in early-stage leiomyosarcoma of the uterus.

Uterine leiomyosarcomas (LMSs) are rare cancers representing less than 1% of all uterine malignancies. Clinical International Federation of Gynecology and Obstetrics (FIGO) stage is the most important prognostic factor. Other significant prognostic factors, especially for early stages, are difficult to establish because most of the published studies have included localized and extra-pelvian sarcomas. The aim of our study was to search for significant prognostic factors in clinical stage I and II uterine LMS. The pathologic features of 108 uterine LMS including 72 stage I and II lesions were reviewed using standardized criteria. The prognostic significance of different pathologic features was assessed. The median follow-up in the whole group was 64 months (range, 6-223 months). The 5-year overall survival (OS) and metastasis-free interval and local relapse-free interval rates in the whole group and early-stage group (FIGO stages I and II) were 40% and 57%, 42% and 50%, 56% and 62%, respectively. Clinical FIGO stage was the most important prognostic factor for OS in the whole group (P = 4 x 10). In the stage I and II group, macroscopic circumscription was the most significant factor predicting OS (P = 0.001). In the same group, mitotic score and vascular invasion were associated with metastasis-free interval (P = 0.03 and P = 0.04, respectively). Uterine LMSs diagnosed using standardized criteria have a poor prognosis, and clinical FIGO stage is an ominous prognostic factor. In early-stage LMS, pathologic features such as mitotic score, vascular invasion, and tumor circumscription significantly impact patient outcome.