Ramey D Littell1, Lue-Yen Tucker2, Tina Raine-Bennett2, Ted E Palen3, Eve Zaritsky4, Romain Neugebauer2, Julia Embry-Schubert3, Scott E Lentz5. 1. Division of Gynecologic Oncology, The Permanente Medical Group, San Francisco, CA, United States. Electronic address: ramey.littell@kp.org. 2. Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States. 3. Colorado Permanente Medical Group, Denver and Aurora, CO, United States. 4. Department of Obstetrics and Gynecology, The Permanente Medical Group, Oakland, CA, United States. 5. Southern California Permanente Medical Group, Los Angeles, CA, United States.
Abstract
OBJECTIVE: To assess recent trends of administering adjuvant gemcitabine-docetaxel (GD) chemotherapy for Stage I uterine leiomyosarcoma, and to compare disease-free and overall survival between women who received and did not receive adjuvant GD chemotherapy. METHODS: All patients diagnosed with Stage I uterine leiomyosarcoma in a California-Colorado population-based health plan inclusive of 2006-2013 were included in a retrospective cohort. Adjuvant GD chemotherapy rates, clinico-pathologic characteristics and survival estimates were assessed. RESULTS: Of 111 women with Stage I uterine leiomyosarcoma, 33 received adjuvant GD (median 4cycles), 77 received no chemotherapy, and 1 patient excluded for non-GD chemotherapy. GD-chemotherapy and no-chemotherapy groups were similar with respect to age, stage (IA/IB), uterine weight, mitotic index, body mass index, and Charlson comorbidity score. Non-Hispanic white women were twice as likely to receive adjuvant chemotherapy as non-white or Hispanic women (37.7 vs. 17.1%, P=0.02). The proportion of women receiving adjuvant GD chemotherapy increased from 6.5% in 2006-2008 to 46.9% in 2009-2013 (P<0.001). There was no significance difference in unadjusted Kaplan-Meyer estimated disease-free (P=0.95) or overall survival (P=0.43) between GD-chemotherapy and no-chemotherapy cohorts. Corresponding adjusted Cox proportional hazard ratios for adjuvant GD chemotherapy compared to no chemotherapy were 1.01 (95% confidence interval [CI] 0.57-1.80, P=0.97) for recurrence and 1.28 (95% CI 0.69-2.36, P-0.48) for mortality. CONCLUSIONS: Use of adjuvant GD chemotherapy for Stage I uterine leiomyosarcoma has increased significantly in the last decade, despite unclear benefit. Compared to no chemotherapy, 4-6cycles of adjuvant GD chemotherapy does not appear to alter survival outcomes.
OBJECTIVE: To assess recent trends of administering adjuvant gemcitabine-docetaxel (GD) chemotherapy for Stage I uterine leiomyosarcoma, and to compare disease-free and overall survival between women who received and did not receive adjuvant GD chemotherapy. METHODS: All patients diagnosed with Stage I uterine leiomyosarcoma in a California-Colorado population-based health plan inclusive of 2006-2013 were included in a retrospective cohort. Adjuvant GD chemotherapy rates, clinico-pathologic characteristics and survival estimates were assessed. RESULTS: Of 111 women with Stage I uterine leiomyosarcoma, 33 received adjuvant GD (median 4cycles), 77 received no chemotherapy, and 1 patient excluded for non-GD chemotherapy. GD-chemotherapy and no-chemotherapy groups were similar with respect to age, stage (IA/IB), uterine weight, mitotic index, body mass index, and Charlson comorbidity score. Non-Hispanic white women were twice as likely to receive adjuvant chemotherapy as non-white or Hispanic women (37.7 vs. 17.1%, P=0.02). The proportion of women receiving adjuvant GD chemotherapy increased from 6.5% in 2006-2008 to 46.9% in 2009-2013 (P<0.001). There was no significance difference in unadjusted Kaplan-Meyer estimated disease-free (P=0.95) or overall survival (P=0.43) between GD-chemotherapy and no-chemotherapy cohorts. Corresponding adjusted Cox proportional hazard ratios for adjuvant GD chemotherapy compared to no chemotherapy were 1.01 (95% confidence interval [CI] 0.57-1.80, P=0.97) for recurrence and 1.28 (95% CI 0.69-2.36, P-0.48) for mortality. CONCLUSIONS: Use of adjuvant GD chemotherapy for Stage I uterine leiomyosarcoma has increased significantly in the last decade, despite unclear benefit. Compared to no chemotherapy, 4-6cycles of adjuvant GD chemotherapy does not appear to alter survival outcomes.
Authors: Rebecca C Arend; Michael D Toboni; Allison M Montgomery; Robert A Burger; Alexander B Olawaiye; Bradley J Monk; Thomas J Herzog Journal: Oncologist Date: 2018-08-23
Authors: Syed Nusrath; Sandeep Bafna; R Rajagopalan; Subramanyeshwar Rao Thammineedi; K V V N Raju; Sujit Chyau Patnaik; Satish Pawar; Yugandhar Reddy; Ramachandra Nagaraju Chavali; Sudha S Murthy Journal: Indian J Surg Oncol Date: 2019-01-05
Authors: David B Chapel; Aarti Sharma; Ricardo R Lastra; Livia Maccio; Emma Bragantini; Gian Franco Zannoni; Suzanne George; Bradley J Quade; Carlos Parra-Herran; Marisa R Nucci Journal: Mod Pathol Date: 2022-02-04 Impact factor: 7.842
Authors: Martee L Hensley; Danielle Enserro; Helen Hatcher; Petronella B Ottevanger; Anders Krarup-Hansen; Jean-Yves Blay; Cyril Fisher; Katherine M Moxley; Shashikant B Lele; Jayanthi S Lea; Krishnansu S Tewari; Premal H Thaker; Oliver Zivanovic; David M O'Malley; Katina Robison; David S Miller Journal: J Clin Oncol Date: 2018-10-05 Impact factor: 44.544