Survival outcome of women with stage IV uterine carcinosarcoma who received neoadjuvant chemotherapy followed by surgery. Issue 3 (16th October 2017)

• Record Type: Journal Article
• Authors: 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.;
• Is Part Of: Journal of surgical oncology. Volume 117:Issue 3(2018)
• Page Start: 488
• Page End: 496
• Publication Date: 2017-10-16
• Subjects: carboplatin -- neoadjuvant chemotherapy -- paclitaxel -- stage IV -- survival outcome -- uterine carcinosarcoma; Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.24861
• Languages: English
• ISSNs: 0022-4790

Abstract

Abstract : 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.