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Survival outcome of women with stage IV uterine carcinosarcoma who received neoadjuvant chemotherapy followed by surgery
Author(s) -
Matsuo Koji,
Johnson Marian S.,
Im Dwight D.,
Ross Malcolm S.,
Bush Stephen H.,
Yunokawa Mayu,
Blake Erin A.,
Takano Tadao,
Klobocista Merieme M.,
Hasegawa Kosei,
Ueda Yutaka,
Shida Masako,
Baba Tsukasa,
Satoh Shinya,
Yokoyama Takuhei,
Machida Hiroko,
Ikeda Yuji,
Adachi Sosuke,
Miyake Takahito M.,
Iwasaki Keita,
Yanai Shiori,
Takeuchi Satoshi,
Nishimura Masato,
Nagano Tadayoshi,
Takekuma Munetaka,
Shahzad Mian M. K.,
Pejovic Tanja,
Omatsu Kohei,
Kelley Joseph L.,
Ueland Frederick R.,
Roman Lynda D.
Publication year - 2018
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24861
Subject(s) - medicine , chemotherapy , carboplatin , hazard ratio , regimen , hysterectomy , oncology , neoadjuvant therapy , surgical oncology , surgery , stage (stratigraphy) , confidence interval , cancer , breast cancer , cisplatin , paleontology , biology
Background and Objectives To examine survival of women with stage IV uterine carcinosarcoma (UCS) who received neoadjuvant chemotherapy followed by hysterectomy. Methods This is a nested case‐control study within a retrospective cohort of 1192 UCS cases. Women who received neoadjuvant chemotherapy followed by hysterectomy based‐surgery for stage IV UCS ( n = 26) were compared to those who had primary hysterectomy‐based surgery without neoadjuvant chemotherapy for stage IV UCS ( n = 120). Progression‐free survival (PFS) and cause‐specific survival (CSS) were examined. Results The most common regimen for neoadjuvant chemotherapy was carboplatin/paclitaxel (53.8%). Median number of neoadjuvant chemotherapy cycles was 4. PFS was similar between the neoadjuvant chemotherapy group and the primary surgery group (unadjusted‐hazard ratio [HR] 1.19, 95% confidence interval [CI] 0.75‐1.89, P = 0.45). Similarly, CSS was comparable between the two groups (unadjusted‐HR 1.13, 95%CI 0.68‐1.90, P = 0.64). When the types of neoadjuvant chemotherapy regimens were compared, women who received a carboplatin/paclitaxel regimen had better survival outcomes compared to those who received other regimens: PFS, unadjusted‐HR 0.38, 95%CI 0.15‐0.93, P = 0.027; and CSS, unadjusted‐HR 0.21, 95%CI 0.07‐0.61, P = 0.002. Conclusion Our study found that there is no statistically significant difference in survival between women with stage IV UCS who are tolerated neoadjuvant chemotherapy and those who undergo primary surgery.