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

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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 languageEnglish (US)
Pages (from-to)488-496
Number of pages9
JournalJournal of Surgical Oncology
Volume117
Issue number3
DOIs
StatePublished - Mar 1 2018

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Keywords

  • carboplatin
  • neoadjuvant chemotherapy
  • paclitaxel
  • stage IV
  • survival outcome
  • uterine carcinosarcoma

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

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