A multi-institutional cohort study of adjuvant therapy in stage I-II uterine carcinosarcoma

Leigh A. Cantrell, Laura Havrilesky, Dominic T. Moore, David O'Malley, Margaret Liotta, Angeles Alvarez Secord, Christa I. Nagel, David E. Cohn, Amanda Nickles Nickles Fader, Amy H. Wallace, Peter Rose, Paola A. Gehrig

Research output: Contribution to journalArticle

Abstract

Objective: To evaluate the impact of adjuvant post-operative therapy in women with early stage uterine carcinosarcoma. Methods: After IRB approval was obtained at all sites, a multi-center retrospective study of women with FIGO stage I-II uterine carcinosarcoma diagnosed from 1997 to 2007 was conducted. Post-operative treatment included observation (OBS), radiation (RT), chemotherapy (CT) alone or with RT (CT + RT). Data analyzed included demographic and pathologic factors, adjuvant therapy outcomes, and time-to-event information. The Kaplan-Meier method was used to estimate time-to-event functions. Cox regression modeling was used to examine the impact of selected covariates on progression free survival (PFS), and overall survival (OS). Results: 111 women were identified: 94 (85%) had stage I and 17 (15%) had stage II uterine carcinosarcoma. Forty-four women (40%) did not receive adjuvant therapy (OBS), 29 (26%) women had adjuvant CT, 23 (20%) women underwent RT and 15 (14%) women underwent RT + CT. Seventy-three patients were alive without disease and 38 had progressed or died at the close of data collection. In multivariate analysis, CT (p = 0.003), LVSI (p <0.0001) and a pre-existing cancer (p = 0.004) were most predictive of PFS. LVSI was predictive of shortened OS (p = 0.01). Conclusions: In women with FIGO stage I-II uterine carcinosarcoma, adjuvant chemotherapy is associated with improved PFS compared to radiation or observation alone. Ongoing clinical trials will clarify the role of chemotherapy in women with this disease.

Original languageEnglish (US)
Pages (from-to)22-26
Number of pages5
JournalGynecologic Oncology
Volume127
Issue number1
DOIs
StatePublished - Oct 2012

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Carcinosarcoma
Cohort Studies
Radiation
Drug Therapy
Disease-Free Survival
Therapeutics
Observation
Adjuvant Chemotherapy
Survival
Research Ethics Committees
Multivariate Analysis
Retrospective Studies
Demography
Clinical Trials

Keywords

  • Carcinosarcoma
  • Early-stage
  • MMMT
  • Therapy

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Cantrell, L. A., Havrilesky, L., Moore, D. T., O'Malley, D., Liotta, M., Secord, A. A., ... Gehrig, P. A. (2012). A multi-institutional cohort study of adjuvant therapy in stage I-II uterine carcinosarcoma. Gynecologic Oncology, 127(1), 22-26. https://doi.org/10.1016/j.ygyno.2012.06.020

A multi-institutional cohort study of adjuvant therapy in stage I-II uterine carcinosarcoma. / Cantrell, Leigh A.; Havrilesky, Laura; Moore, Dominic T.; O'Malley, David; Liotta, Margaret; Secord, Angeles Alvarez; Nagel, Christa I.; Cohn, David E.; Nickles Fader, Amanda Nickles; Wallace, Amy H.; Rose, Peter; Gehrig, Paola A.

In: Gynecologic Oncology, Vol. 127, No. 1, 10.2012, p. 22-26.

Research output: Contribution to journalArticle

Cantrell, LA, Havrilesky, L, Moore, DT, O'Malley, D, Liotta, M, Secord, AA, Nagel, CI, Cohn, DE, Nickles Fader, AN, Wallace, AH, Rose, P & Gehrig, PA 2012, 'A multi-institutional cohort study of adjuvant therapy in stage I-II uterine carcinosarcoma', Gynecologic Oncology, vol. 127, no. 1, pp. 22-26. https://doi.org/10.1016/j.ygyno.2012.06.020
Cantrell LA, Havrilesky L, Moore DT, O'Malley D, Liotta M, Secord AA et al. A multi-institutional cohort study of adjuvant therapy in stage I-II uterine carcinosarcoma. Gynecologic Oncology. 2012 Oct;127(1):22-26. https://doi.org/10.1016/j.ygyno.2012.06.020
Cantrell, Leigh A. ; Havrilesky, Laura ; Moore, Dominic T. ; O'Malley, David ; Liotta, Margaret ; Secord, Angeles Alvarez ; Nagel, Christa I. ; Cohn, David E. ; Nickles Fader, Amanda Nickles ; Wallace, Amy H. ; Rose, Peter ; Gehrig, Paola A. / A multi-institutional cohort study of adjuvant therapy in stage I-II uterine carcinosarcoma. In: Gynecologic Oncology. 2012 ; Vol. 127, No. 1. pp. 22-26.
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abstract = "Objective: To evaluate the impact of adjuvant post-operative therapy in women with early stage uterine carcinosarcoma. Methods: After IRB approval was obtained at all sites, a multi-center retrospective study of women with FIGO stage I-II uterine carcinosarcoma diagnosed from 1997 to 2007 was conducted. Post-operative treatment included observation (OBS), radiation (RT), chemotherapy (CT) alone or with RT (CT + RT). Data analyzed included demographic and pathologic factors, adjuvant therapy outcomes, and time-to-event information. The Kaplan-Meier method was used to estimate time-to-event functions. Cox regression modeling was used to examine the impact of selected covariates on progression free survival (PFS), and overall survival (OS). Results: 111 women were identified: 94 (85{\%}) had stage I and 17 (15{\%}) had stage II uterine carcinosarcoma. Forty-four women (40{\%}) did not receive adjuvant therapy (OBS), 29 (26{\%}) women had adjuvant CT, 23 (20{\%}) women underwent RT and 15 (14{\%}) women underwent RT + CT. Seventy-three patients were alive without disease and 38 had progressed or died at the close of data collection. In multivariate analysis, CT (p = 0.003), LVSI (p <0.0001) and a pre-existing cancer (p = 0.004) were most predictive of PFS. LVSI was predictive of shortened OS (p = 0.01). Conclusions: In women with FIGO stage I-II uterine carcinosarcoma, adjuvant chemotherapy is associated with improved PFS compared to radiation or observation alone. Ongoing clinical trials will clarify the role of chemotherapy in women with this disease.",
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AU - Moore, Dominic T.

AU - O'Malley, David

AU - Liotta, Margaret

AU - Secord, Angeles Alvarez

AU - Nagel, Christa I.

AU - Cohn, David E.

AU - Nickles Fader, Amanda Nickles

AU - Wallace, Amy H.

AU - Rose, Peter

AU - Gehrig, Paola A.

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N2 - Objective: To evaluate the impact of adjuvant post-operative therapy in women with early stage uterine carcinosarcoma. Methods: After IRB approval was obtained at all sites, a multi-center retrospective study of women with FIGO stage I-II uterine carcinosarcoma diagnosed from 1997 to 2007 was conducted. Post-operative treatment included observation (OBS), radiation (RT), chemotherapy (CT) alone or with RT (CT + RT). Data analyzed included demographic and pathologic factors, adjuvant therapy outcomes, and time-to-event information. The Kaplan-Meier method was used to estimate time-to-event functions. Cox regression modeling was used to examine the impact of selected covariates on progression free survival (PFS), and overall survival (OS). Results: 111 women were identified: 94 (85%) had stage I and 17 (15%) had stage II uterine carcinosarcoma. Forty-four women (40%) did not receive adjuvant therapy (OBS), 29 (26%) women had adjuvant CT, 23 (20%) women underwent RT and 15 (14%) women underwent RT + CT. Seventy-three patients were alive without disease and 38 had progressed or died at the close of data collection. In multivariate analysis, CT (p = 0.003), LVSI (p <0.0001) and a pre-existing cancer (p = 0.004) were most predictive of PFS. LVSI was predictive of shortened OS (p = 0.01). Conclusions: In women with FIGO stage I-II uterine carcinosarcoma, adjuvant chemotherapy is associated with improved PFS compared to radiation or observation alone. Ongoing clinical trials will clarify the role of chemotherapy in women with this disease.

AB - Objective: To evaluate the impact of adjuvant post-operative therapy in women with early stage uterine carcinosarcoma. Methods: After IRB approval was obtained at all sites, a multi-center retrospective study of women with FIGO stage I-II uterine carcinosarcoma diagnosed from 1997 to 2007 was conducted. Post-operative treatment included observation (OBS), radiation (RT), chemotherapy (CT) alone or with RT (CT + RT). Data analyzed included demographic and pathologic factors, adjuvant therapy outcomes, and time-to-event information. The Kaplan-Meier method was used to estimate time-to-event functions. Cox regression modeling was used to examine the impact of selected covariates on progression free survival (PFS), and overall survival (OS). Results: 111 women were identified: 94 (85%) had stage I and 17 (15%) had stage II uterine carcinosarcoma. Forty-four women (40%) did not receive adjuvant therapy (OBS), 29 (26%) women had adjuvant CT, 23 (20%) women underwent RT and 15 (14%) women underwent RT + CT. Seventy-three patients were alive without disease and 38 had progressed or died at the close of data collection. In multivariate analysis, CT (p = 0.003), LVSI (p <0.0001) and a pre-existing cancer (p = 0.004) were most predictive of PFS. LVSI was predictive of shortened OS (p = 0.01). Conclusions: In women with FIGO stage I-II uterine carcinosarcoma, adjuvant chemotherapy is associated with improved PFS compared to radiation or observation alone. Ongoing clinical trials will clarify the role of chemotherapy in women with this disease.

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