Impact of chemotherapy in uterine sarcoma (UtS): Review of 13 clinical trials from the EORTC Soft Tissue and Bone Sarcoma Group (STBSG) involving advanced/metastatic UtS compared to other soft tissue sarcoma (STS) patients treated with first line chemotherapy

I. Ray-Coquard, E. Rizzo, J. Y. Blay, P. Casali, I. Judson, A. Krarup Hansen, L. H. Lindner, A. P. Dei Tos, H. Gelderblom, S. Marreaud, S. Litière, P. Rutkowski, P. Hohenberger, A. Gronchi, W. T. Van Der Graaf

Research output: Contribution to journalArticlepeer-review

Abstract

Objective UtS are a group of uncommon tumors representing 1% of malignant neoplasms of the female genital tract, and 7% of sarcomas. The objective of this study was to evaluate the factors associated with the clinical behavior UtS. Methods Information on 269 patients with advanced or metastatic first line UtS treated by chemotherapy was available in a database containing information on 3270 patients with advanced soft tissue sarcomas (STS) entered in EORTC-STBSG clinical trials between 1977 and 2010. The chemotherapy was aggregated in 4 categories: anthracyclines alone, ifosfamide alone, the combination of doxorubicin and ifosfamide, and CYVADIC. Results Among the 269 UtS pts, there were 231 deaths (median OS 10.4 months, 95% CI: 9.1-11.9) and 257 progressions and/or deaths (median PFS 4.1 months, 95% CI: 3.5-4.9). Multivariate analyses reported PS (p <0.001) only to be a statistically significant prognostic factor for OS in UtS; for PFS, LMS histology (p = 0.025) is associated with a better outcome. There was no relationship between the 4 groups of chemotherapy regimens and impact on clinical outcomes. Histological subtype was significantly correlated with response to chemotherapy (RR: LMS 19% vs other 33%, p = 0.026). Ifosfamide single agent yielded only 5% of RR. Conclusions Clearly, UtS are very aggressive neoplasms with poor outcome when treated with chemotherapy consisting of anthracyclines with or without ifosfamide or cyclophosphamide. New strategies are urgently needed.

Original languageEnglish
Pages (from-to)95-101
Number of pages7
JournalGynecologic Oncology
Volume142
Issue number1
DOIs
Publication statusPublished - Jul 1 2016

Keywords

  • Chemotherapy
  • Sarcoma
  • Treatment
  • Uterine

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Oncology

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