Premium
Primary ovarian sarcoma
Author(s) -
Sood Anil K.,
Sorosky Joel I.,
Gelder Mark S.,
Buller Richard E.,
Anderson Barrie,
Wilkinson Edward J.,
Benda Jo A.,
Morgan Linda S.
Publication year - 1998
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19980501)82:9<1738::aid-cncr21>3.0.co;2-4
Subject(s) - medicine , ovarian cancer , chemotherapy , sarcoma , univariate analysis , stage (stratigraphy) , histology , oncology , surgery , cancer , multivariate analysis , pathology , paleontology , biology
BACKGROUND Data regarding the value of cytoreduction and cell histology in ovarian sarcomas are limited. The goal of this study was to assess the value of surgical cytoreduction, preoperative CA 125 levels, stage, histology, and platinum‐based chemotherapy in the primary treatment of ovarian sarcomas. METHODS A retrospective analysis of 47 women with primary ovarian sarcomas was performed. RESULTS Forty‐one patients (87%) presented with advanced stage disease (International Federation of Gynecology and Obstetrics Stage III or IV). Optimal surgical cytoreduction (<1 cm residual tumor burden) was achieved in 25 patients (53%). Forty patients (85%) had a malignant mixed müllerian tumor whereas 7 patients had a pure sarcoma. Eighteen women with mixed müllerian tumors had homologous tumors and 22 had heterologous elements. Patients treated with platinum‐based chemotherapy were significantly more likely to have a response ( P = 0.008) compared with those treated with other regimens. Treatment with platinum‐based chemotherapy also showed a survival advantage ( P = 0.03). Preoperative CA 125 levels were elevated (>35 U/mL) in 93% of patients with ovarian sarcomas. A preoperative CA 125 level < 75 U/mL was significantly associated with better survival ( P = 0.01). In univariate analysis, other significant predictors of improved survival were early stage ( P = 0.04), homologous tumors ( P < 0.05), and optimal surgical cytoreduction ( P < 0.001). In multivariate analysis of various prognostic variables, optimal surgical cytoreduction ( P < 0.001) was the most significant factor, followed by histologic subtype ( P < 0.02). CONCLUSIONS Ovarian sarcomas are rare malignancies with a poor prognosis. All women with suspected ovarian carcinoma or sarcoma should have a preoperative CA 125 level taken. Surgical cytoreduction to a residual tumor burden of ≤1 cm improves outcome and should be the goal of surgery. Although the optimal consolidation chemotherapy regimen remains unknown, platinum should be included as part of the regimen. Cancer 1998;82:1731‐7. © 1998 American Cancer Society.