TY - JOUR
T1 - Survival outcome of women with stage IV uterine carcinosarcoma who received neoadjuvant chemotherapy followed by surgery
AU - Matsuo, Koji
AU - Johnson, Marian S.
AU - Im, Dwight D.
AU - Ross, Malcolm S.
AU - Bush, Stephen H.
AU - Yunokawa, Mayu
AU - Blake, Erin A.
AU - Takano, Tadao
AU - Klobocista, Merieme M.
AU - Hasegawa, Kosei
AU - Ueda, Yutaka
AU - Shida, Masako
AU - Baba, Tsukasa
AU - Satoh, Shinya
AU - Yokoyama, Takuhei
AU - Machida, Hiroko
AU - Ikeda, Yuji
AU - Adachi, Sosuke
AU - Miyake, Takahito M.
AU - Iwasaki, Keita
AU - Yanai, Shiori
AU - Takeuchi, Satoshi
AU - Nishimura, Masato
AU - Nagano, Tadayoshi
AU - Takekuma, Munetaka
AU - Shahzad, Mian M.K.
AU - Pejovic, Tanja
AU - Omatsu, Kohei
AU - Kelley, Joseph L.
AU - Ueland, Frederick R.
AU - Roman, Lynda D.
N1 - Publisher Copyright:
© 2017 Wiley Periodicals, Inc.
PY - 2018/3/1
Y1 - 2018/3/1
N2 - 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.
AB - 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.
KW - carboplatin
KW - neoadjuvant chemotherapy
KW - paclitaxel
KW - stage IV
KW - survival outcome
KW - uterine carcinosarcoma
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U2 - 10.1002/jso.24861
DO - 10.1002/jso.24861
M3 - Article
C2 - 29044542
AN - SCOPUS:85043992558
SN - 0022-4790
VL - 117
SP - 488
EP - 496
JO - Journal of Surgical Oncology
JF - Journal of Surgical Oncology
IS - 3
ER -