Efficacy of adjuvant chemotherapy in early stage uterine leiomyosarcoma: A systematic review and meta-analysis

Bogani, Giorgio; Fucà, Giovanni; Maltese, Giuseppa; Ditto, Antonino; Martinelli, Fabio; Signorelli, Mauro; Chiappa, Valentina; Scaffa, Cono; Sabatucci, Ilaria; Lecce, Francesca; Raspagliesi, Francesco; Lorusso, Domenica

doi:10.1016/j.ygyno.2016.07.110

Cited by 48 publications

(32 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…After disease has spread beyond the uterus, the likelihood of achieving long-term survival is low with current therapeutics. 18 Bogani et al 19 evaluated the efficacy of ACT, but disease-free survival (DFS) was not improved. Notably, patients undergoing chemotherapy experienced no survival benefit compared with patients who underwent observation only.…”

Section: Discussionmentioning

confidence: 99%

Retrospective analysis of treatment and prognosis for uterine leiomyosarcoma: 10‐year experience of a single institute

Kodama

Sonoda

Kijima

et al. 2019

Asia-Pac J Clncl Oncology

View full text Add to dashboard Cite

Aim Uterine leiomyosarcoma (ULMS) is a highly aggressive and lethal disease. This malignancy remains the most common type of uterine sarcoma, affecting approximately 0.4/100 000 women each year. Our aim was to assess the treatment and prognosis of ULMS patients. Methods A total of 14 patients were treated at our institution between January 2008 and July 2017. We retrospectively analyzed their clinicopathological variables, treatment and prognosis. Results The median patient age was 63 years (range, 35–83 years). The largest group of patients had stage IB disease (stage IB, n = 8; IIB, n = 2; IIIB, n = 1; IVB, n = 3) and the largest group by histological subtype was ordinary (ordinary, n = 11; myxoid, n = 2; epithelioid, n = 1). Total abdominal hysterectomy and bilateral salpingo‐oophorectomy were performed for all patients, with additional surgical procedures (e.g., tumor resection, lymphadenectomy) performed if necessary. Twelve patients received adjuvant chemotherapy (ACT) consisting of gemcitabine and docetaxel. Ten patients experienced recurrence and received multidisciplinary therapies, including tumor resection, chemotherapy, radiation and targeted therapies. The median observation period was 17 months (range, 5–75 months), and 11 patients were alive (without disease, n = 5; with disease, n = 6). Intriguingly, five of eight stage IB patients who received postoperative ACT were alive without disease. Conclusion ULMS is rare but is associated with a poor prognosis, even if multidisciplinary therapies are administered. However, ACT appears to be effective in improving the prognosis of patients with stage IB disease.

show abstract

Section: Discussionmentioning

confidence: 99%

Retrospective analysis of treatment and prognosis for uterine leiomyosarcoma: 10‐year experience of a single institute

Kodama

Sonoda

Kijima

et al. 2019

Asia-Pac J Clncl Oncology

View full text Add to dashboard Cite

show abstract

“…There are limited studies examining the role of adjuvant chemotherapy in early‐stage LMS. A recent systematic meta‐analysis of literature that included five studies (total 360 patients) found no benefit in PFS in patients who received chemotherapy compared with the radiotherapy or observation groups . Included in this analysis is the Gynecologic Oncology Group (GOG) study comparing single agent doxorubicin in a small randomized controlled trial in patients with LMS and carcinosarcoma, with or without radiation, and found lower rates of recurrence but no difference in PFS or OS .…”

Section: Management Of Early‐stage Uterine Lmsmentioning

confidence: 99%

Uterine leiomyosarcoma: a review of recent advances in molecular biology, clinical management and outcome

Cui

Wright

Hou

2017

BJOG

View full text Add to dashboard Cite

show abstract

“…ULMS has poor prognosis and high recurrence rate [ 2 – 4 ]. Currently, the treatment of ULMS is mostly by surgery with some adjuvant therapies, such as cytotoxic chemotherapy and radiotherapy [ 5 – 7 ]. Due to the complex molecular heterogeneity of ULMS and unavailability of targeted therapeutic methods, the five-year survival rate of ULMS is still low [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Distinct molecular subtypes of uterine leiomyosarcoma respond differently to chemotherapy treatment

Wang

et al. 2017

BMC Cancer

View full text Add to dashboard Cite

BackgroundUterine leiomyosarcoma (ULMS) is an aggressive form of soft tissue tumors. The molecular heterogeneity and pathogenesis of ULMS are not well understood.MethodsExpression profiling data were used to determine the possibility and optimal number of ULMS molecular subtypes. Next, clinicopathological characters and molecular pathways were analyzed in each subtype to prospect the clinical applications and progression mechanisms of ULMS.ResultsTwo distinct molecular subtypes of ULMS were defined based on different gene expression signatures. Subtype I ULMS recapitulated low-grade ULMS, the gene expression pattern of which resembled normal smooth muscle cells, characterized by overexpression of smooth muscle function genes such as LMOD1, SLMAP, MYLK, MYH11. In contrast, subtype II ULMS recapitulated high-grade ULMS with higher tumor weight and invasion rate, and was characterized by overexpression of genes involved in the pathway of epithelial to mesenchymal transition and tumorigenesis, such as CDK6, MAPK13 and HOXA1.ConclusionsWe identified two distinct molecular subtypes of ULMS responding differently to chemotherapy treatment. Our findings provide a better understanding of ULMS intrinsic molecular subtypes, and will potentially facilitate the development of subtype-specific diagnosis biomarkers and therapy strategies for these tumors.Electronic supplementary materialThe online version of this article (10.1186/s12885-017-3568-y) contains supplementary material, which is available to authorized users.

show abstract

Efficacy of adjuvant chemotherapy in early stage uterine leiomyosarcoma: A systematic review and meta-analysis

Cited by 48 publications

References 17 publications

Retrospective analysis of treatment and prognosis for uterine leiomyosarcoma: 10‐year experience of a single institute

Retrospective analysis of treatment and prognosis for uterine leiomyosarcoma: 10‐year experience of a single institute

Uterine leiomyosarcoma: a review of recent advances in molecular biology, clinical management and outcome

Distinct molecular subtypes of uterine leiomyosarcoma respond differently to chemotherapy treatment

Contact Info

Product

Resources

About