Prognostic factors and impact of adjuvant chemotherapy for uterine leiomyosarcoma

Tzu I. Wu, Ting Chang Chang, Swei Hsueh, Kuang Hung Hsu, Hung Hsueh Chou, Huei Jean Huang, Chyong Huey Lai

Research output: Contribution to journalArticle

67 Citations (Scopus)

Abstract

Objective. The aim of this study was to investigate prognostic factors and impact of adjuvant therapy for uterine leiomyosarcoma (LMS). Methods. All cases with uterine LMS were retrieved from medical registry (1984 through 2003) of Chang Gung Memorial Hospital. After excluding cases with initial surgery at outside the hospital, missing chart, and wrong pathologic diagnosis, 51 patients (41 for stage I, 7 for stage III, and 3 for stage IV) met the study criteria. Approximate stratified analysis and Cox proportional hazards model were used to adjust confounding factors. Results. The median follow-up for survivors was 47 months. Five-year overall survival and recurrence-free survival (RFS) rates were 67.4% and 59.2% for the whole series. Multivariate Cox regression analyses selected age (>50 versus ≤50 years: relative risk [RR], 11.07 [95% CI 1.53-80.34]), tumor size (>11 versus ≤11 cm: RR, 11.63 [95% CI 2.14-63.12]), stage (III and IV versus I: RR, 21.24 [95% CI 2.20-204.98]), and adjuvant chemotherapy (yes versus no: RR, 0.08 [95% CI 0.01-0.81]) as significant predictors of death. Besides, surgical stage (P = 0.021), tumor size (P = 0.005), and adjuvant chemotherapy (P = 0.011) were significantly correlated with RFS. After approximate stratification, the use of adjuvant chemotherapy also significantly decreased RR of death. Conclusions. This is the first report to demonstrate benefit of adjuvant chemotherapy for LMS despite the limitation of sample size and its retrospective nature. Prospective multicenter trials are necessary to clarify the role of chemotherapy, selecting criteria, and optimal chemotherapy regimen for uterine LMS.

Original languageEnglish
Pages (from-to)166-172
Number of pages7
JournalGynecologic Oncology
Volume100
Issue number1
DOIs
Publication statusPublished - Jan 2006
Externally publishedYes

Fingerprint

Leiomyosarcoma
Adjuvant Chemotherapy
Recurrence
Drug Therapy
Survival
Proportional Hazards Models
Sample Size
Multicenter Studies
Survivors
Registries
Neoplasms
Survival Rate
Regression Analysis

Keywords

  • Adjuvant therapy
  • Chemotherapy
  • Prognostic factors
  • Uterine leiomyosarcoma

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Oncology

Cite this

Wu, T. I., Chang, T. C., Hsueh, S., Hsu, K. H., Chou, H. H., Huang, H. J., & Lai, C. H. (2006). Prognostic factors and impact of adjuvant chemotherapy for uterine leiomyosarcoma. Gynecologic Oncology, 100(1), 166-172. https://doi.org/10.1016/j.ygyno.2005.08.010

Prognostic factors and impact of adjuvant chemotherapy for uterine leiomyosarcoma. / Wu, Tzu I.; Chang, Ting Chang; Hsueh, Swei; Hsu, Kuang Hung; Chou, Hung Hsueh; Huang, Huei Jean; Lai, Chyong Huey.

In: Gynecologic Oncology, Vol. 100, No. 1, 01.2006, p. 166-172.

Research output: Contribution to journalArticle

Wu, TI, Chang, TC, Hsueh, S, Hsu, KH, Chou, HH, Huang, HJ & Lai, CH 2006, 'Prognostic factors and impact of adjuvant chemotherapy for uterine leiomyosarcoma', Gynecologic Oncology, vol. 100, no. 1, pp. 166-172. https://doi.org/10.1016/j.ygyno.2005.08.010
Wu, Tzu I. ; Chang, Ting Chang ; Hsueh, Swei ; Hsu, Kuang Hung ; Chou, Hung Hsueh ; Huang, Huei Jean ; Lai, Chyong Huey. / Prognostic factors and impact of adjuvant chemotherapy for uterine leiomyosarcoma. In: Gynecologic Oncology. 2006 ; Vol. 100, No. 1. pp. 166-172.
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abstract = "Objective. The aim of this study was to investigate prognostic factors and impact of adjuvant therapy for uterine leiomyosarcoma (LMS). Methods. All cases with uterine LMS were retrieved from medical registry (1984 through 2003) of Chang Gung Memorial Hospital. After excluding cases with initial surgery at outside the hospital, missing chart, and wrong pathologic diagnosis, 51 patients (41 for stage I, 7 for stage III, and 3 for stage IV) met the study criteria. Approximate stratified analysis and Cox proportional hazards model were used to adjust confounding factors. Results. The median follow-up for survivors was 47 months. Five-year overall survival and recurrence-free survival (RFS) rates were 67.4{\%} and 59.2{\%} for the whole series. Multivariate Cox regression analyses selected age (>50 versus ≤50 years: relative risk [RR], 11.07 [95{\%} CI 1.53-80.34]), tumor size (>11 versus ≤11 cm: RR, 11.63 [95{\%} CI 2.14-63.12]), stage (III and IV versus I: RR, 21.24 [95{\%} CI 2.20-204.98]), and adjuvant chemotherapy (yes versus no: RR, 0.08 [95{\%} CI 0.01-0.81]) as significant predictors of death. Besides, surgical stage (P = 0.021), tumor size (P = 0.005), and adjuvant chemotherapy (P = 0.011) were significantly correlated with RFS. After approximate stratification, the use of adjuvant chemotherapy also significantly decreased RR of death. Conclusions. This is the first report to demonstrate benefit of adjuvant chemotherapy for LMS despite the limitation of sample size and its retrospective nature. Prospective multicenter trials are necessary to clarify the role of chemotherapy, selecting criteria, and optimal chemotherapy regimen for uterine LMS.",
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T1 - Prognostic factors and impact of adjuvant chemotherapy for uterine leiomyosarcoma

AU - Wu, Tzu I.

AU - Chang, Ting Chang

AU - Hsueh, Swei

AU - Hsu, Kuang Hung

AU - Chou, Hung Hsueh

AU - Huang, Huei Jean

AU - Lai, Chyong Huey

PY - 2006/1

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N2 - Objective. The aim of this study was to investigate prognostic factors and impact of adjuvant therapy for uterine leiomyosarcoma (LMS). Methods. All cases with uterine LMS were retrieved from medical registry (1984 through 2003) of Chang Gung Memorial Hospital. After excluding cases with initial surgery at outside the hospital, missing chart, and wrong pathologic diagnosis, 51 patients (41 for stage I, 7 for stage III, and 3 for stage IV) met the study criteria. Approximate stratified analysis and Cox proportional hazards model were used to adjust confounding factors. Results. The median follow-up for survivors was 47 months. Five-year overall survival and recurrence-free survival (RFS) rates were 67.4% and 59.2% for the whole series. Multivariate Cox regression analyses selected age (>50 versus ≤50 years: relative risk [RR], 11.07 [95% CI 1.53-80.34]), tumor size (>11 versus ≤11 cm: RR, 11.63 [95% CI 2.14-63.12]), stage (III and IV versus I: RR, 21.24 [95% CI 2.20-204.98]), and adjuvant chemotherapy (yes versus no: RR, 0.08 [95% CI 0.01-0.81]) as significant predictors of death. Besides, surgical stage (P = 0.021), tumor size (P = 0.005), and adjuvant chemotherapy (P = 0.011) were significantly correlated with RFS. After approximate stratification, the use of adjuvant chemotherapy also significantly decreased RR of death. Conclusions. This is the first report to demonstrate benefit of adjuvant chemotherapy for LMS despite the limitation of sample size and its retrospective nature. Prospective multicenter trials are necessary to clarify the role of chemotherapy, selecting criteria, and optimal chemotherapy regimen for uterine LMS.

AB - Objective. The aim of this study was to investigate prognostic factors and impact of adjuvant therapy for uterine leiomyosarcoma (LMS). Methods. All cases with uterine LMS were retrieved from medical registry (1984 through 2003) of Chang Gung Memorial Hospital. After excluding cases with initial surgery at outside the hospital, missing chart, and wrong pathologic diagnosis, 51 patients (41 for stage I, 7 for stage III, and 3 for stage IV) met the study criteria. Approximate stratified analysis and Cox proportional hazards model were used to adjust confounding factors. Results. The median follow-up for survivors was 47 months. Five-year overall survival and recurrence-free survival (RFS) rates were 67.4% and 59.2% for the whole series. Multivariate Cox regression analyses selected age (>50 versus ≤50 years: relative risk [RR], 11.07 [95% CI 1.53-80.34]), tumor size (>11 versus ≤11 cm: RR, 11.63 [95% CI 2.14-63.12]), stage (III and IV versus I: RR, 21.24 [95% CI 2.20-204.98]), and adjuvant chemotherapy (yes versus no: RR, 0.08 [95% CI 0.01-0.81]) as significant predictors of death. Besides, surgical stage (P = 0.021), tumor size (P = 0.005), and adjuvant chemotherapy (P = 0.011) were significantly correlated with RFS. After approximate stratification, the use of adjuvant chemotherapy also significantly decreased RR of death. Conclusions. This is the first report to demonstrate benefit of adjuvant chemotherapy for LMS despite the limitation of sample size and its retrospective nature. Prospective multicenter trials are necessary to clarify the role of chemotherapy, selecting criteria, and optimal chemotherapy regimen for uterine LMS.

KW - Adjuvant therapy

KW - Chemotherapy

KW - Prognostic factors

KW - Uterine leiomyosarcoma

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