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

Authors
 Se Ik Kim  ;  Chel Hun Choi  ;  Kidong Kim  ;  Deok Ho Hong  ;  Jeong-Yeol Park  ;  Byung Su Kwon  ;  Keun Ho Lee  ;  Dae Gy Hong  ;  So-Jin Shin  ;  Sang-Il Park  ;  Yun Hwan Kim  ;  Seung-Ho Lee  ;  Sanghoon Lee  ;  Jin Hwa Hong  ;  Jung-Yun Lee  ;  Yong Beom Kim  ;  Jae Hong No  ;  Dong Hoon Suh 
Citation
 JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH, Vol.46(2) : 337-346, 2020-02 
Journal Title
JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH
ISSN
 1341-8076 
Issue Date
2020-02
MeSH
Adult ; Combined Modality Therapy / statistics & numerical data* ; Female ; Humans ; Leiomyosarcoma / mortality ; Leiomyosarcoma / therapy* ; Middle Aged ; Morcellation* ; Retrospective Studies ; Uterine Neoplasms / mortality ; Uterine Neoplasms / therapy*
Keywords
adjuvant treatment ; leiomyosarcoma ; prognosis ; recurrence ; survival ; uterine 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.
Full Text
https://obgyn.onlinelibrary.wiley.com/doi/10.1111/jog.14171
DOI
10.1111/jog.14171
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Jung-Yun(이정윤) ORCID logo https://orcid.org/0000-0001-7948-1350
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/190239
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