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

Research output: Contribution to journalArticle

4 Citations (Scopus)

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
Pages (from-to)488-496
Number of pages9
JournalJournal of Surgical Oncology
Volume117
Issue number3
DOIs
Publication statusPublished - Mar 2018
Externally publishedYes

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Carcinosarcoma
Drug Therapy
Survival
Hysterectomy
Confidence Intervals
Disease-Free Survival
Carboplatin
Paclitaxel
Case-Control Studies

Keywords

  • Antineoplastic Combined Chemotherapy Protocols/therapeutic use
  • Carboplatin/administration & dosage
  • Carcinosarcoma/drug therapy
  • Case-Control Studies
  • Chemotherapy, Adjuvant
  • Cohort Studies
  • Disease-Free Survival
  • Female
  • Humans
  • Hysterectomy
  • Middle Aged
  • Neoadjuvant Therapy
  • Neoplasm Staging
  • Paclitaxel/administration & dosage
  • Retrospective Studies
  • Uterine Neoplasms/drug therapy

Cite this

Matsuo, K., Johnson, M. S., Im, D. D., Ross, M. S., Bush, S. H., Yunokawa, 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

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

In: Journal of Surgical Oncology, Vol. 117, No. 3, 03.2018, p. 488-496.

Research output: Contribution to journalArticle

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
Matsuo, Koji ; Johnson, Marian S ; Im, Dwight D ; Ross, Malcolm S ; Bush, Stephen H ; Yunokawa, Mayu ; Blake, Erin A ; Takano, Tadao ; Klobocista, Merieme M ; Hasegawa, Kosei ; Ueda, Yutaka ; Shida, Masako ; Baba, Tsukasa ; Satoh, Shinya ; Yokoyama, Takuhei ; Machida, Hiroko ; Ikeda, Yuji ; Adachi, Sosuke ; Miyake, Takahito M ; Iwasaki, Keita ; Yanai, Shiori ; Takeuchi, Satoshi ; Nishimura, Masato ; Nagano, Tadayoshi ; Takekuma, Munetaka ; Shahzad, Mian M K ; Pejovic, Tanja ; Omatsu, Kohei ; Kelley, Joseph L ; Ueland, Frederick R ; Roman, Lynda D. / Survival outcome of women with stage IV uterine carcinosarcoma who received neoadjuvant chemotherapy followed by surgery. In: Journal of Surgical Oncology. 2018 ; Vol. 117, No. 3. pp. 488-496.
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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.",
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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}",
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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

N1 - © 2017 Wiley Periodicals, Inc.

PY - 2018/3

Y1 - 2018/3

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 - Antineoplastic Combined Chemotherapy Protocols/therapeutic use

KW - Carboplatin/administration & dosage

KW - Carcinosarcoma/drug therapy

KW - Case-Control Studies

KW - Chemotherapy, Adjuvant

KW - Cohort Studies

KW - Disease-Free Survival

KW - Female

KW - Humans

KW - Hysterectomy

KW - Middle Aged

KW - Neoadjuvant Therapy

KW - Neoplasm Staging

KW - Paclitaxel/administration & dosage

KW - Retrospective Studies

KW - Uterine Neoplasms/drug therapy

U2 - 10.1002/jso.24861

DO - 10.1002/jso.24861

M3 - Article

C2 - 29044542

VL - 117

SP - 488

EP - 496

JO - Journal of Surgical Oncology

JF - Journal of Surgical Oncology

SN - 0022-4790

IS - 3

ER -