Survival outcome of women with stage IV uterine carcinosarcoma who received neoadjuvant chemotherapy followed by surgery

Koji Matsuo; Marian S. Johnson; Dwight D. Im; Malcolm S. Ross; Stephen H. Bush; Mayu Yunokawa; Erin A. Blake; Tadao Takano; Merieme M. Klobocista; Kosei Hasegawa; Yutaka Ueda; Masako Shida; Tsukasa Baba; Shinya Satoh; Takuhei Yokoyama; Hiroko Machida; Yuji Ikeda; Sosuke Adachi; Takahito M. Miyake; Keita Iwasaki; Shiori Yanai; Satoshi Takeuchi; Masato Nishimura; Tadayoshi Nagano; Munetaka Takekuma; Mian M.K. Shahzad; Tanja Pejovic; Kohei Omatsu; Joseph L. Kelley; Frederick R. Ueland; Lynda D. Roman

doi:10.1002/jso.24861

Survival outcome of women with stage IV uterine carcinosarcoma who received neoadjuvant chemotherapy followed by surgery

Koji Matsuo, Marian S. Johnson, Dwight D. Im, Malcolm S. Ross, Stephen H. Bush, Mayu Yunokawa, Erin A. Blake, Tadao Takano, Merieme M. Klobocista, Kosei Hasegawa, Yutaka Ueda, Masako Shida, Tsukasa Baba, Shinya Satoh, Takuhei Yokoyama, Hiroko Machida, Yuji Ikeda, Sosuke Adachi, Takahito M. Miyake, Keita IwasakiShiori Yanai, Satoshi Takeuchi, Masato Nishimura, Tadayoshi Nagano, Munetaka Takekuma, Mian M.K. Shahzad, Tanja Pejovic, Kohei Omatsu, Joseph L. Kelley, Frederick R. Ueland, Lynda D. Roman

Obstetrics and Gynecology

Research output: Contribution to journal › Article › peer-review

11 Scopus citations

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.

Original language	English (US)
Pages (from-to)	488-496
Number of pages	9
Journal	Journal of surgical oncology
Volume	117
Issue number	3
DOIs	https://doi.org/10.1002/jso.24861
State	Published - Mar 1 2018

Keywords

carboplatin
neoadjuvant chemotherapy
paclitaxel
stage IV
survival outcome
uterine carcinosarcoma

ASJC Scopus subject areas

Surgery
Oncology

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10.1002/jso.24861

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Matsuo, K., Johnson, M. S., Im, D. D., Ross, M. S., Bush, S. H., Yunokawa, M., Blake, E. A., Takano, T., Klobocista, M. M., Hasegawa, K., Ueda, Y., Shida, M., Baba, T., Satoh, S., Yokoyama, T., Machida, H., Ikeda, Y., Adachi, S., Miyake, T. M., ... Roman, L. D. (2018). Survival outcome of women with stage IV uterine carcinosarcoma who received neoadjuvant chemotherapy followed by surgery. Journal of surgical oncology, 117(3), 488-496. https://doi.org/10.1002/jso.24861

Matsuo, K, Johnson, MS, Im, DD, Ross, MS, Bush, SH, Yunokawa, M, Blake, EA, Takano, T, Klobocista, MM, Hasegawa, K, Ueda, Y, Shida, M, Baba, T, Satoh, S, Yokoyama, T, Machida, H, Ikeda, Y, Adachi, S, Miyake, TM, Iwasaki, K, Yanai, S, Takeuchi, S, Nishimura, M, Nagano, T, Takekuma, M, Shahzad, MMK, Pejovic, T, Omatsu, K, Kelley, JL, Ueland, FR & Roman, LD 2018, 'Survival outcome of women with stage IV uterine carcinosarcoma who received neoadjuvant chemotherapy followed by surgery', Journal of surgical oncology, vol. 117, no. 3, pp. 488-496. https://doi.org/10.1002/jso.24861

@article{2b6d0d41ef5047fea7d5ec66b2b21a52,

title = "Survival outcome of women with stage IV uterine carcinosarcoma who received neoadjuvant chemotherapy followed by surgery",

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.",

keywords = "carboplatin, neoadjuvant chemotherapy, paclitaxel, stage IV, survival outcome, uterine carcinosarcoma",

author = "Koji Matsuo and Johnson, {Marian S.} and Im, {Dwight D.} and Ross, {Malcolm S.} and Bush, {Stephen H.} and Mayu Yunokawa and Blake, {Erin A.} and Tadao Takano and Klobocista, {Merieme M.} and Kosei Hasegawa and Yutaka Ueda and Masako Shida and Tsukasa Baba and Shinya Satoh and Takuhei Yokoyama and Hiroko Machida and Yuji Ikeda and Sosuke Adachi and Miyake, {Takahito M.} and Keita Iwasaki and Shiori Yanai and Satoshi Takeuchi and Masato Nishimura and Tadayoshi Nagano and Munetaka Takekuma and Shahzad, {Mian M.K.} and Tanja Pejovic and Kohei Omatsu and Kelley, {Joseph L.} and Ueland, {Frederick R.} and Roman, {Lynda D.}",

note = "Publisher Copyright: {\textcopyright} 2017 Wiley Periodicals, Inc.",

year = "2018",

month = mar,

day = "1",

doi = "10.1002/jso.24861",

language = "English (US)",

volume = "117",

pages = "488--496",

journal = "Journal of surgical oncology",

issn = "0022-4790",

publisher = "Wiley-Liss Inc.",

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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.

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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M3 - Article

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Survival outcome of women with stage IV uterine carcinosarcoma who received neoadjuvant chemotherapy followed by surgery

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