TY - JOUR
T1 - A multi-institutional cohort study of adjuvant therapy in stage I-II uterine carcinosarcoma
AU - Cantrell, Leigh A.
AU - Havrilesky, Laura
AU - Moore, Dominic T.
AU - O'Malley, David
AU - Liotta, Margaret
AU - Secord, Angeles Alvarez
AU - Nagel, Christa I.
AU - Cohn, David E.
AU - Fader, Amanda Nickles
AU - Wallace, Amy H.
AU - Rose, Peter
AU - Gehrig, Paola A.
PY - 2012/10
Y1 - 2012/10
N2 - Objective: To evaluate the impact of adjuvant post-operative therapy in women with early stage uterine carcinosarcoma. Methods: After IRB approval was obtained at all sites, a multi-center retrospective study of women with FIGO stage I-II uterine carcinosarcoma diagnosed from 1997 to 2007 was conducted. Post-operative treatment included observation (OBS), radiation (RT), chemotherapy (CT) alone or with RT (CT + RT). Data analyzed included demographic and pathologic factors, adjuvant therapy outcomes, and time-to-event information. The Kaplan-Meier method was used to estimate time-to-event functions. Cox regression modeling was used to examine the impact of selected covariates on progression free survival (PFS), and overall survival (OS). Results: 111 women were identified: 94 (85%) had stage I and 17 (15%) had stage II uterine carcinosarcoma. Forty-four women (40%) did not receive adjuvant therapy (OBS), 29 (26%) women had adjuvant CT, 23 (20%) women underwent RT and 15 (14%) women underwent RT + CT. Seventy-three patients were alive without disease and 38 had progressed or died at the close of data collection. In multivariate analysis, CT (p = 0.003), LVSI (p < 0.0001) and a pre-existing cancer (p = 0.004) were most predictive of PFS. LVSI was predictive of shortened OS (p = 0.01). Conclusions: In women with FIGO stage I-II uterine carcinosarcoma, adjuvant chemotherapy is associated with improved PFS compared to radiation or observation alone. Ongoing clinical trials will clarify the role of chemotherapy in women with this disease.
AB - Objective: To evaluate the impact of adjuvant post-operative therapy in women with early stage uterine carcinosarcoma. Methods: After IRB approval was obtained at all sites, a multi-center retrospective study of women with FIGO stage I-II uterine carcinosarcoma diagnosed from 1997 to 2007 was conducted. Post-operative treatment included observation (OBS), radiation (RT), chemotherapy (CT) alone or with RT (CT + RT). Data analyzed included demographic and pathologic factors, adjuvant therapy outcomes, and time-to-event information. The Kaplan-Meier method was used to estimate time-to-event functions. Cox regression modeling was used to examine the impact of selected covariates on progression free survival (PFS), and overall survival (OS). Results: 111 women were identified: 94 (85%) had stage I and 17 (15%) had stage II uterine carcinosarcoma. Forty-four women (40%) did not receive adjuvant therapy (OBS), 29 (26%) women had adjuvant CT, 23 (20%) women underwent RT and 15 (14%) women underwent RT + CT. Seventy-three patients were alive without disease and 38 had progressed or died at the close of data collection. In multivariate analysis, CT (p = 0.003), LVSI (p < 0.0001) and a pre-existing cancer (p = 0.004) were most predictive of PFS. LVSI was predictive of shortened OS (p = 0.01). Conclusions: In women with FIGO stage I-II uterine carcinosarcoma, adjuvant chemotherapy is associated with improved PFS compared to radiation or observation alone. Ongoing clinical trials will clarify the role of chemotherapy in women with this disease.
KW - Carcinosarcoma
KW - Early-stage
KW - MMMT
KW - Therapy
UR - http://www.scopus.com/inward/record.url?scp=84865687098&partnerID=8YFLogxK
U2 - 10.1016/j.ygyno.2012.06.020
DO - 10.1016/j.ygyno.2012.06.020
M3 - Article
C2 - 22727985
AN - SCOPUS:84865687098
SN - 0090-8258
VL - 127
SP - 22
EP - 26
JO - Gynecologic Oncology
JF - Gynecologic Oncology
IS - 1
ER -