I Ray-Coquard1, E Rizzo2, J Y Blay3, P Casali4, I Judson5, A Krarup Hansen6, L H Lindner7, A P Dei Tos8, H Gelderblom9, S Marreaud2, S Litière2, P Rutkowski10, P Hohenberger11, A Gronchi4, W T van der Graaf12. 1. Département de Cancérologie médicale, Centre, Léon Bérard, Lyon, France. Electronic address: isabelle.ray-coquard@lyon.unicancer.fr. 2. European Organisation for Research and Treatment of Cancer Headquarters, Brussels, Belgium. 3. Département de Cancérologie médicale, Centre, Léon Bérard, Lyon, France. 4. Fondazione IRCCS Instituto Nazionale dei Tumori, Milan, Italy. 5. Royal Marsden Hospital, Chelsea, London, UK. 6. Herlev Hospital, Copenhagen University, Herlev, Denmark. 7. Klinikum der Universitaet Muenchen, Campus Grosshadern, Muenchen, Germany. 8. Ospedale Regionale "Ca' Foncello", Treviso, Italy. 9. Leiden University Medical Centre, Leiden, the Netherlands. 10. Maria Sklodowska-Curie Memorial Cancer Centre, Warsaw, Poland. 11. Mannheim University Medical Center, Mannheim, Germany. 12. The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London, UK.
Abstract
OBJECTIVE: UtS are a group of uncommon tumors representing 1% of malignant neoplasms of the female genital tract, and 7% of sarcomas. The objective of this study was to evaluate the factors associated with the clinical behavior UtS. METHODS: Information on 269 patients with advanced or metastatic first line UtS treated by chemotherapy was available in a database containing information on 3270 patients with advanced soft tissue sarcomas (STS) entered in EORTC-STBSG clinical trials between 1977 and 2010. The chemotherapy was aggregated in 4 categories: anthracyclines alone, ifosfamide alone, the combination of doxorubicin and ifosfamide, and CYVADIC. RESULTS: Among the 269 UtS pts, there were 231 deaths (median OS 10.4months, 95% CI: 9.1-11.9) and 257 progressions and/or deaths (median PFS 4.1months, 95% CI: 3.5-4.9). Multivariate analyses reported PS (p<0.001) only to be a statistically significant prognostic factor for OS in UtS; for PFS, LMS histology (p=0.025) is associated with a better outcome. There was no relationship between the 4 groups of chemotherapy regimens and impact on clinical outcomes. Histological subtype was significantly correlated with response to chemotherapy (RR: LMS 19% vs other 33%, p=0.026). Ifosfamide single agent yielded only 5% of RR. CONCLUSIONS: Clearly, UtS are very aggressive neoplasms with poor outcome when treated with chemotherapy consisting of anthracyclines with or without ifosfamide or cyclophosphamide. New strategies are urgently needed.
OBJECTIVE: UtS are a group of uncommon tumors representing 1% of malignant neoplasms of the female genital tract, and 7% of sarcomas. The objective of this study was to evaluate the factors associated with the clinical behavior UtS. METHODS: Information on 269 patients with advanced or metastatic first line UtS treated by chemotherapy was available in a database containing information on 3270 patients with advanced soft tissue sarcomas (STS) entered in EORTC-STBSG clinical trials between 1977 and 2010. The chemotherapy was aggregated in 4 categories: anthracyclines alone, ifosfamide alone, the combination of doxorubicin and ifosfamide, and CYVADIC. RESULTS: Among the 269 UtS pts, there were 231 deaths (median OS 10.4months, 95% CI: 9.1-11.9) and 257 progressions and/or deaths (median PFS 4.1months, 95% CI: 3.5-4.9). Multivariate analyses reported PS (p<0.001) only to be a statistically significant prognostic factor for OS in UtS; for PFS, LMS histology (p=0.025) is associated with a better outcome. There was no relationship between the 4 groups of chemotherapy regimens and impact on clinical outcomes. Histological subtype was significantly correlated with response to chemotherapy (RR: LMS 19% vs other 33%, p=0.026). Ifosfamide single agent yielded only 5% of RR. CONCLUSIONS: Clearly, UtS are very aggressive neoplasms with poor outcome when treated with chemotherapy consisting of anthracyclines with or without ifosfamide or cyclophosphamide. New strategies are urgently needed.