Secondary cytoreduction in the management of recurrent uterine leiomyosarcoma

Robert L. Giuntoli, Elizabeth Garrett-Mayer, Robert E. Bristow, Bobbie S. Gostout

Research output: Contribution to journalArticle

Abstract

Objectives: To identify effective treatment options for patients with recurrent uterine leiomyosarcoma (LMS). Methods: Patients with uterine LMS treated between 1976 and 1999 were identified. Charts were retrospectively reviewed and relevant clinical and pathologic data extracted. Survival curves were generated using the methods of Kaplan and Meier. Multivariate analysis was performed using the Cox proportional model. Results: Chart review identified 128 patients with recurrent uterine LMS. The median time to recurrence was 1.3 years. The median disease-specific survival from the time of first recurrence was 1.8 years. Multivariate analysis demonstrated secondary cytoreductive surgery, prolonged time to recurrence and localized recurrence were significantly and independently associated with improved disease-specific survival from time of first recurrence. Neither chemotherapy nor radiation therapy was associated with improvement in outcome in patients with recurrent uterine LMS. Conclusions: These data suggest that secondary cytoreductive surgery is associated with prolonged survival in a select group of patients with recurrent uterine LMS. Patients presenting after a prolonged progression-free interval with an isolated site of recurrence amenable to complete resection are the best candidates for attempted surgical resection. These findings require confirmation from a larger and preferably prospectively gathered database.

Original languageEnglish (US)
Pages (from-to)82-88
Number of pages7
JournalGynecologic Oncology
Volume106
Issue number1
DOIs
StatePublished - Jul 2007

Fingerprint

Leiomyosarcoma
Recurrence
Survival
Multivariate Analysis
Proportional Hazards Models
Radiotherapy
Databases
Drug Therapy

Keywords

  • Recurrence
  • Retrospective study
  • Secondary cytoreductive surgery
  • Uterine leiomyosarcoma

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Giuntoli, R. L., Garrett-Mayer, E., Bristow, R. E., & Gostout, B. S. (2007). Secondary cytoreduction in the management of recurrent uterine leiomyosarcoma. Gynecologic Oncology, 106(1), 82-88. https://doi.org/10.1016/j.ygyno.2007.02.031

Secondary cytoreduction in the management of recurrent uterine leiomyosarcoma. / Giuntoli, Robert L.; Garrett-Mayer, Elizabeth; Bristow, Robert E.; Gostout, Bobbie S.

In: Gynecologic Oncology, Vol. 106, No. 1, 07.2007, p. 82-88.

Research output: Contribution to journalArticle

Giuntoli, RL, Garrett-Mayer, E, Bristow, RE & Gostout, BS 2007, 'Secondary cytoreduction in the management of recurrent uterine leiomyosarcoma', Gynecologic Oncology, vol. 106, no. 1, pp. 82-88. https://doi.org/10.1016/j.ygyno.2007.02.031
Giuntoli, Robert L. ; Garrett-Mayer, Elizabeth ; Bristow, Robert E. ; Gostout, Bobbie S. / Secondary cytoreduction in the management of recurrent uterine leiomyosarcoma. In: Gynecologic Oncology. 2007 ; Vol. 106, No. 1. pp. 82-88.
@article{e63f017c990a4a6389b7d3c12c28f7fa,
title = "Secondary cytoreduction in the management of recurrent uterine leiomyosarcoma",
abstract = "Objectives: To identify effective treatment options for patients with recurrent uterine leiomyosarcoma (LMS). Methods: Patients with uterine LMS treated between 1976 and 1999 were identified. Charts were retrospectively reviewed and relevant clinical and pathologic data extracted. Survival curves were generated using the methods of Kaplan and Meier. Multivariate analysis was performed using the Cox proportional model. Results: Chart review identified 128 patients with recurrent uterine LMS. The median time to recurrence was 1.3 years. The median disease-specific survival from the time of first recurrence was 1.8 years. Multivariate analysis demonstrated secondary cytoreductive surgery, prolonged time to recurrence and localized recurrence were significantly and independently associated with improved disease-specific survival from time of first recurrence. Neither chemotherapy nor radiation therapy was associated with improvement in outcome in patients with recurrent uterine LMS. Conclusions: These data suggest that secondary cytoreductive surgery is associated with prolonged survival in a select group of patients with recurrent uterine LMS. Patients presenting after a prolonged progression-free interval with an isolated site of recurrence amenable to complete resection are the best candidates for attempted surgical resection. These findings require confirmation from a larger and preferably prospectively gathered database.",
keywords = "Recurrence, Retrospective study, Secondary cytoreductive surgery, Uterine leiomyosarcoma",
author = "Giuntoli, {Robert L.} and Elizabeth Garrett-Mayer and Bristow, {Robert E.} and Gostout, {Bobbie S.}",
year = "2007",
month = "7",
doi = "10.1016/j.ygyno.2007.02.031",
language = "English (US)",
volume = "106",
pages = "82--88",
journal = "Gynecologic Oncology",
issn = "0090-8258",
publisher = "Academic Press Inc.",
number = "1",

}

TY - JOUR

T1 - Secondary cytoreduction in the management of recurrent uterine leiomyosarcoma

AU - Giuntoli, Robert L.

AU - Garrett-Mayer, Elizabeth

AU - Bristow, Robert E.

AU - Gostout, Bobbie S.

PY - 2007/7

Y1 - 2007/7

N2 - Objectives: To identify effective treatment options for patients with recurrent uterine leiomyosarcoma (LMS). Methods: Patients with uterine LMS treated between 1976 and 1999 were identified. Charts were retrospectively reviewed and relevant clinical and pathologic data extracted. Survival curves were generated using the methods of Kaplan and Meier. Multivariate analysis was performed using the Cox proportional model. Results: Chart review identified 128 patients with recurrent uterine LMS. The median time to recurrence was 1.3 years. The median disease-specific survival from the time of first recurrence was 1.8 years. Multivariate analysis demonstrated secondary cytoreductive surgery, prolonged time to recurrence and localized recurrence were significantly and independently associated with improved disease-specific survival from time of first recurrence. Neither chemotherapy nor radiation therapy was associated with improvement in outcome in patients with recurrent uterine LMS. Conclusions: These data suggest that secondary cytoreductive surgery is associated with prolonged survival in a select group of patients with recurrent uterine LMS. Patients presenting after a prolonged progression-free interval with an isolated site of recurrence amenable to complete resection are the best candidates for attempted surgical resection. These findings require confirmation from a larger and preferably prospectively gathered database.

AB - Objectives: To identify effective treatment options for patients with recurrent uterine leiomyosarcoma (LMS). Methods: Patients with uterine LMS treated between 1976 and 1999 were identified. Charts were retrospectively reviewed and relevant clinical and pathologic data extracted. Survival curves were generated using the methods of Kaplan and Meier. Multivariate analysis was performed using the Cox proportional model. Results: Chart review identified 128 patients with recurrent uterine LMS. The median time to recurrence was 1.3 years. The median disease-specific survival from the time of first recurrence was 1.8 years. Multivariate analysis demonstrated secondary cytoreductive surgery, prolonged time to recurrence and localized recurrence were significantly and independently associated with improved disease-specific survival from time of first recurrence. Neither chemotherapy nor radiation therapy was associated with improvement in outcome in patients with recurrent uterine LMS. Conclusions: These data suggest that secondary cytoreductive surgery is associated with prolonged survival in a select group of patients with recurrent uterine LMS. Patients presenting after a prolonged progression-free interval with an isolated site of recurrence amenable to complete resection are the best candidates for attempted surgical resection. These findings require confirmation from a larger and preferably prospectively gathered database.

KW - Recurrence

KW - Retrospective study

KW - Secondary cytoreductive surgery

KW - Uterine leiomyosarcoma

UR - http://www.scopus.com/inward/record.url?scp=34250186054&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34250186054&partnerID=8YFLogxK

U2 - 10.1016/j.ygyno.2007.02.031

DO - 10.1016/j.ygyno.2007.02.031

M3 - Article

C2 - 17434579

AN - SCOPUS:34250186054

VL - 106

SP - 82

EP - 88

JO - Gynecologic Oncology

JF - Gynecologic Oncology

SN - 0090-8258

IS - 1

ER -