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

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Author(s)
Se Ik KimChel Hun ChoiKidong KimDeok Ho HongJeong-Yeol ParkByung Su KwonKeun Ho LeeDae Gy HongSo-Jin ShinSang-Il ParkYun Hwan KimSeung-Ho LeeSanghoon LeeJin Hwa HongJung-Yun LeeYong Beom KimJae Hong NoDong Hoon Suh
Keimyung Author(s)
Shin, So Jin
Department
Dept. of Obstetrics & Gynecology (산부인과학)
Journal Title
The journal of obstetrics and gynaecology research.
Issued Date
2019
Volume
46
Issue
2
Keyword
adjuvant treatmentleiomyosarcomaprognosisrecurrencesurvivaluterine neoplasms
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.
Keimyung Author(s)(Kor)
신소진
Publisher
School of Medicine (의과대학)
Citation
Se Ik Kim et al. (2019). Effectiveness of adjuvant treatment for morcellated, International Federation of Gynecology and Obstetrics stage I uterine leiomyosarcoma: A Korean multicenter study. The journal of obstetrics and gynaecology research., 46(2), 337–346. doi: 10.1111/jog.14171
Type
Article
ISSN
1447-0756
Source
https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/jog.14171
DOI
10.1111/jog.14171
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/42641
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Obstetrics & Gynecology (산부인과학)
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