Open AccessRetrospective analysis of adjuvant treatment for localized, operable uterine leiomyosarcoma
Author(s) -
Chantharasamee Jomjit,
Wong Karlton,
Potivongsajarn Pasathorn,
Qorbani Amir,
Motamed Neda,
Brackert Sandra,
Cohen Joshua,
Chmielowski Bartosz,
Kalbasi Anusha,
Rao Jianyu,
Nelson Scott,
Singh Arun
Publication year - 2022
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.4665
Subject(s) - medicine , adjuvant , adjuvant therapy , radiation therapy , univariate analysis , surgery , chemotherapy , retrospective cohort study , leiomyosarcoma , oncology , multivariate analysis
Objective Currently, there is no standard adjuvant treatment protocol for localized uterine leiomyosarcoma (uLMS) as clinical trials to address this question have been retrospective, underpowered, or undermined by slow accrual rates. The aim of this study is to determine the benefit of adjuvant chemotherapy for uLMS. Methods We reviewed the medical records of localized uLMS patients who had underwent adjuvant therapy after upfront surgery between 2000 and 2020. The cases were blinded for review. We evaluated the influence of various clinical characteristics and different types of adjuvant therapies on specific outcomes. Results Sixty‐eight patients (median age: 50 years) were included for analysis. Forty of 68 (58.8%) patients received adjuvant chemotherapy +/− radiation therapy and 25 patients (38.6%) did not receive any adjuvant therapy. At a median follow‐up time of 43.3 months, 45 patients (66.1%) had relapsed disease. The median disease‐free survival (mDFS) for all patients was 23.1 months. Patients who received any adjuvant treatment (chemotherapy and/or radiation) trended toward a longer mDFS compared with those who did not receive any adjuvant therapy (29.7 vs. 14.1 months, p = 0.26). Patients who received adjuvant chemotherapy alone had a longer, but nonstatistically significant mDFS compared with those who did not receive any adjuvant treatment (22.2 vs. 14.1 months, p = 0.18). Additionally, univariate analysis found that tumor size large than 10 cm, and a mitotic rate >10/10hpf were independent prognostic factors for worse DFS. Conclusions Though DFS was more favorable among those who received adjuvant therapy, it was not statistically significant, and thus based on this data adjuvant therapy for resected uLMS is still in question.