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Effectiveness of adjuvant treatment for morcellated, International Federation of Gynecology and Obstetrics stage I uterine leiomyosarcoma: A Korean multicenter study

Title
Effectiveness of adjuvant treatment for morcellated, International Federation of Gynecology and Obstetrics stage I uterine leiomyosarcoma: A Korean multicenter study
Authors
Kim, Se IkChoi, Chel HunKim, KidongHong, Deok HoPark, Jeong-YeolKwon, Byung SuLee, Keun HoHong, Dae GyShin, So-JinPark, Sang-IlKim, Yun HwanLee, Seung-HoLee, SanghoonHong, Jin HwaLee, Jung-YunKim, Yong BeomNo, Jae HongSuh, Dong Hoon
Ewha Authors
김윤환
SCOPUS Author ID
김윤환scopus
Issue Date
2020
Journal Title
JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH
ISSN
1341-8076JCR Link

1447-0756JCR Link
Citation
JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH vol. 46, no. 2, pp. 337 - 346
Keywords
adjuvant treatmentleiomyosarcomaprognosisrecurrencesurvivaluterine neoplasms
Publisher
WILEY
Indexed
SCIE; SCOPUS WOS
Document Type
Article
Abstract
Aim To evaluate the effectiveness of adjuvant treatment for morcellated, uterus-confined leiomyosarcoma in a multicenter setting. Methods We identified patients with International Federation of Gynecology and Obstetrics stage I uterine leiomyosarcoma primarily treated with surgery between 2003 and 2016. Among them, patients who underwent one of the following morcellation methods were included: (i) power morcellation; (ii) intracorporeal morcellation using scalpels or electrocautery; and (iii) vaginal morcellation. Patients' survival outcomes were compared according to the implementation of adjuvant treatment. Results From 13 institutions, 55 patients were included; 31 for adjuvant treatment group and 24 for surgery only group. The clinicopathological characteristics including the mass size, morcellation methods, extent of surgery, and mitotic count were similar between the groups. In the adjuvant treatment group, 67.7%, 19.4% and 12.9% of patients received chemotherapy, chemoradiation and radiation, respectively. After a median follow-up of 50.5 months, the adjuvant treatment and surgery only groups showed similar overall survival (5-year rate, 92.0% vs 90.4%; P = 0.959). No significant difference in progression-free survival was observed between the two groups (3-year rate, 46.1% vs 78.2%; P = 0.069). On multivariate analyses, adjuvant treatment did not affect progression-free survival (adjusted HR, 2.138; 95% CI, 0.550-8.305; P = 0.273). The adjuvant treatment group showed a trend towards more common distant metastasis, compared to the surgery only group (25.8% vs 4.2%; P = 0.062). The incidences of pelvic, retroperitoneal, and abdominal recurrences were not different between the groups. Conclusion Despite its frequent use in clinical practice, adjuvant treatment did not improve the survival outcomes of patients with morcellated, International Federation of Gynecology and Obstetrics stage I uterine leiomyosarcoma.
DOI
10.1111/jog.14171
Appears in Collections:
의과대학 > 의학과 > Journal papers
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