Impact of adjuvant treatment on oncologic outcomes in patients with stage I leiomyosarcoma of the uterus

Impact of adjuvant treatment on oncologic outcomes in patients with stage I leiomyosarcoma of the uterus

Background/aim: This study aimed to evaluate the role of adjuvant therapy for stage I uterine leiomyosarcoma (LMS). Materials and methods: Clinicopathological data of cases of stage I uterine LMS from 1998 to 2015 were retrieved from the computerized database of Hacettepe University Hospital. The Kaplan Meier method was used to estimate survival and progression-free survival, and survival differences were analyzed by log-rank test. Cox regression analysis was performed to account for the potential influence of confounding factors. Results: We evaluated the outcomes of 35 patients with histologically proven stage I LMS. The median age at diagnosis was 50 years. All patients underwent surgical treatment and 20 patients (57.1%) received adjuvant therapy. Twelve of these patients (34.3%) received adjuvant chemotherapy, 3 (8.6%) received adjuvant pelvic irradiation, and 5 (14.2%) received adjuvant chemotherapy with pelvic irradiation. The median follow-up duration was 34 months (range: 3 231 months). Twenty-three (65.7%) patients had a recurrence during follow-up. Adjuvant therapy did not significantly improve median progression-free survival or median overall survival. Cox regression analysis did not demonstrate any significant impact of the factors studied, including age, menopausal status, tumor size, mitotic count, staging surgery, or adjuvant therapy. Conclusion: Adjuvant therapy for surgically treated stage I uterine LMS did not improve oncologic outcomes.

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  • 1. Trope CG, VM Abeler, GB Kristensen. Diagnosis and treatment of sarcoma of the uterus. A review. Acta Oncol 2012; 51: 694- 705.
  • 2. Giuntoli RL,  Metzinger DS,  DiMarco CS,  Cha SS,  Sloan JA,  Keeney GL,  Gostout BS. Retrospective review of 208 patients with leiomyosarcoma of the uterus: prognostic indicators, surgical management, and adjuvant therapy. Gynecol Oncol 2003; 89: 460-469.
  • 3. D’Angelo E, Espinosa I, Ali R, Gilks CB, Rijn Mv, Lee CH, Prat J. Uterine leiomyosarcomas: tumor size, mitotic index, and biomarkers Ki67, and Bcl-2 identify two groups with different prognosis. Gynecol Oncol 2011; 121: 328-333.
  • 4. Kapp DS, Shin JY, Chan JK. Prognostic factors and survival in 1396 patients with uterine leiomyosarcomas: emphasis on impact of lymphadenectomy and oophorectomy. Cancer 2008; 112: 820-830.
  • 5. Prat J. FIGO staging for uterine sarcomas. Int J Gynaecol Obstet 2009; 104: 177-178.
  • 6. Dusenbery KE, Potish RA, Judson P. Limitations of adjuvant radiotherapy for uterine sarcomas spread beyond the uterus. Gynecol Oncol 2004; 94: 191-196.
  • 7. Dinh TA,  Oliva EA,  Fuller AF Jr,  Lee H,  Goodman A. The treatment of uterine leiomyosarcoma. Results from a 10-year experience (1990-1999) at the Massachusetts General Hospital. Gynecol Oncol 2004; 92: 648-652.
  • 8. Amant F,  Coosemans A,  Debiec-Rychter M,  Timmerman D, Vergote I. Clinical management of uterine sarcomas. Lancet Oncol 2009; 10: 1188-1198.
  • 9. Major FJ,  Blessing JA,  Silverberg SG,  Morrow CP,  Creasman WT,  Currie JL,  Yordan E,  Brady MF. Prognostic factors in early-stage uterine sarcoma. A Gynecologic Oncology Group study. Cancer 1993; 71: 1702-1709.
  • 10. Amant F,  Coosemans A,  Renard V,  Everaert E,  Vergote I. Clinical outcome of ET-743 (Trabectedin; Yondelis) in highgrade uterine sarcomas: report on five patients and a review of the literature. Int J Gynecol Cancer 2009; 19: 245-248.
  • 11. Abeler VM,  Røyne O,  Thoresen S,  Danielsen HE,  Nesland JM,  Kristensen GB. Uterine sarcomas in Norway. A histopathological and prognostic survey of a total population from 1970 to 2000 including 419 patients. Histopathology 2009; 54: 355-364.
  • 12. D’Angelo E, Prat J. Uterine sarcomas: a review. Gynecol Oncol 2010; 116: 131-139.
  • 13. Omura GA, Blessing JA, Major F, Lifshitz S, Ehrlich CE, Mangan C, Beecham J, Park R, Silverberg S. A randomized clinical trial of adjuvant adriamycin in uterine sarcomas: a Gynecologic Oncology Group Study. J Clin Oncol 1985; 3: 1240-1245.
  • 14. Hensley ML,  Ishill N,  Soslow R,  Larkin J,  Abu-Rustum N, Sabbatini P, Konner J, Tew W, Spriggs D, Aghajanian CA. Adjuvant gemcitabine plus docetaxel for completely resected stages I-IV high grade uterine leiomyosarcoma: results of a prospective study. Gynecol Oncol 2009; 112: 563-567.
  • 15. Hensley ML,  Wathen JK,  Maki RG,  Araujo DM,  Sutton G,  Priebat DA,  George S,  Soslow RA,  Baker LH. Adjuvant therapy for high-grade, uterus-limited leiomyosarcoma: results of a phase 2 trial (SARC 005). Cancer 2013; 119: 1555-1561.
  • 16. Piver MS, Lele SB, Marchetti DL, Emrich LJ. Effect of adjuvant chemotherapy on time to recurrence and survival of stage I uterine sarcomas. J Surg Oncol 1988; 38: 233-239.
  • 17. Park JY, Kim DY, Suh DS, Kim JH, Kim YM, Kim YT, Nam JH. Prognostic factors and treatment outcomes of patients with uterine sarcoma: analysis of 127 patients at a single institution, 1989-2007. J Cancer Res Clin Oncol 2008; 134: 1277-1287.
  • 18. Hsieh CH, Lin H, Huang CC, Huang EY, Chang SY, ChangChien CC. Leiomyosarcoma of the uterus: a clinicopathologic study of 21 cases. Acta Obstet Gynecol Scand 2003; 82: 74-81.
  • 19. Durnali A, Tokluoğlu S, Özdemir N, Inanç M, Alkiş N, Zengin N, Sönmez ÖU, Küçüköner M; Anatolian Society of Medical Oncology (ASMO). Prognostic factors and treatment outcomes in 93 patients with uterine sarcoma from 4 centers in Turkey. Asian Pac J Cancer Prev 2012; 13: 1935-1941.
  • 20. Reed NS,  Mangioni C,  Malmström H,  Scarfone G,  Poveda A,  Pecorelli S,  Tateo S,  Franchi M,  Jobsen JJ,  Coens C et al. Phase III randomised study to evaluate the role of adjuvant pelvic radiotherapy in the treatment of uterine sarcomas stages I and II: an European Organisation for Research and Treatment of Cancer Gynaecological Cancer Group Study (protocol 55874). Eur J Cancer 2008; 44: 808-818.
  • 21. Chauveinc L, Deniaud E, Plancher C, Sastre X, Amsani F, de la Rochefordiere A, Rozemberg H, Clough KB. Uterine sarcomas: the Curie Institut experience. Prognosis factors and adjuvant treatments. Gynecol Oncol 1999; 72: 232-237.
  • 22. Salazar OM,  Bonfiglio TA,  Patten SF,  Keller BE,  Feldstein M, Dunne ME, Rudolph J. Uterine sarcomas: natural history, treatment and prognosis. Cancer 1978; 42: 1152-1160.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
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