Research Article
BibTex RIS Cite
Year 2021, Volume: 4 Issue: 6, 795 - 799, 24.09.2021
https://doi.org/10.32322/jhsm.963151

Abstract

References

  • D’Angelo E, Prat J. Uterine sarcomas: a review. Gynecol Oncol 2010; 116: 131-9.
  • Society AC. Cancer facts & figures 2018. Atlanta, GA2018.
  • Ricci S, Stone RL, Fader AN. Uterine leiomyosarcoma: Epidemiology, contemporary treatment strategies and the impact of uterine morcellation. Gynecol Oncol 2017; 145: 208-16.
  • Ganjoo KN. Uterine sarcomas. Curr Probl Cancer 2019; 43: 283-8.
  • Giuntoli RL, 2nd, Metzinger DS, DiMarco CS, et al. Retrospective review of 208 patients with leiomyosarcoma of the uterus: prognostic indicators, surgical management, and adjuvant therapy. Gynecol Oncol 2003; 89: 460-9.
  • Kapp DS, Shin JY, Chan JK. Prognostic factors and survival in 1396 patients with uterine leiomyosarcomas: emphasis on impact of lymphadenectomy and oophorectomy. Cancer. 2008; 112: 820-30.
  • Kanjeekal S, Chambers A, Fung MF, Verma S. Systemic therapy for advanced uterine sarcoma: a systematic review of the literature. Gynecol Oncol 2005; 97: 624-37.
  • Li J, Chen X, Hu X. High-intensity focused ultrasound for treatment of recurrent uterine leiomyosarcoma: a case report and literature review. J Int Med Res 2020; 48: 300060520942107.
  • Maki RG, Wathen JK, Patel SR, et al. Randomized phase II study of gemcitabine and docetaxel compared with gemcitabine alone in patients with metastatic soft tissue sarcomas: results of sarcoma alliance for research through collaboration study 002. J Clin Oncol 2007; 25: 2755-63.
  • Toro JR, Travis LB, Wu HJ, Zhu K, Fletcher CD, Devesa SS. Incidence patterns of soft tissue sarcomas, regardless of primary site, in the surveillance, epidemiology and end results program, 1978-2001: An analysis of 26,758 cases. Int J Cancer 2006; 119: 2922-30.
  • Desar IME, Ottevanger PB, Benson C, van der Graaf WTA. Systemic treatment in adult uterine sarcomas. Crit Rev Oncol Hematol 2018; 122: 10-20.
  • Hensley ML, Maki R, Venkatraman E, et al. Gemcitabine and docetaxel in patients with unresectable leiomyosarcoma: results of a phase II trial. J Clin Oncol 2002; 20: 2824-31.
  • Hensley ML, Blessing JA, Mannel R, Rose PG. Fixed-dose rate gemcitabine plus docetaxel as first-line therapy for metastatic uterine leiomyosarcoma: a Gynecologic Oncology Group phase II trial. Gynecol Oncol 2008; 109: 329-34.
  • Seagle BL, Sobecki-Rausch J, Strohl AE, Shilpi A, Grace A, Shahabi S. Prognosis and treatment of uterine leiomyosarcoma: A National Cancer Database study. Gynecol Oncol 2017; 145: 61-70.
  • Judson I, Verweij J, Gelderblom H, et al. Doxorubicin alone versus intensified doxorubicin plus ifosfamide for first-line treatment of advanced or metastatic soft-tissue sarcoma: a randomised controlled phase 3 trial. Lancet Oncol 2014; 15: 415-23.
  • Seddon B, Strauss SJ, Whelan J, et al. Gemcitabine and docetaxel versus doxorubicin as first-line treatment in previously untreated advanced unresectable or metastatic soft-tissue sarcomas (GeDDiS): a randomised controlled phase 3 trial. Lancet Oncol 2017; 18: 1397-410.
  • Abeler VM, Røyne O, Thoresen S, Danielsen HE, Nesland JM, Kristensen GB. Uterine sarcomas in Norway. A histopathological and prognostic survey of a total population from 1970 to 2000 including 419 patients. Histopathology 2009; 54: 355-64.
  • Mayerhofer K, Obermair A, Windbichler G, et al. Leiomyosarcoma of the uterus: a clinicopathologic multicenter study of 71 cases. Gynecol Oncol 1999; 74: 196-201.
  • Bernstein-Molho R, Grisaro D, Soyfer V, Safra T, Merimsky O. Metastatic uterine leiomyosarcomas: a single-institution experience. Int J Gynecol Cancer 2010; 20: 255-60.
  • Giuntoli RL, 2nd, Garrett-Mayer E, Bristow RE, Gostout BS. Secondary cytoreduction in the management of recurrent uterine leiomyosarcoma. Gynecol Oncol 2007; 106: 82-8.

First-line palliative chemotherapy clinical benefit is a key determinant of survival in metastatic uterine leiomyosarcoma

Year 2021, Volume: 4 Issue: 6, 795 - 799, 24.09.2021
https://doi.org/10.32322/jhsm.963151

Abstract

Aim: To evaluate whether obtaining a clinical benefit with first-line therapy in patients receiving palliative systemic therapy with a diagnosis of metastatic uterine leiomyosarcoma (ULMS) provides a survival benefit and the factors that may predict first-line therapy response.
Material and Method: This study was a retrospective observational single-center analysis conducted with patients diagnosed with metastatic ULMS. Patients who received palliative chemotherapy with an ECOG PS of 0 or 1 at the time of diagnosis of metastatic disease were included in the study. Main patient characteristics, first-line palliative treatment responses, progression-free survival, and overall survival (OS) were reviewed retrospectively. Multivariate analyses were performed to determine the independent predictive factors of first-line palliative treatment response and overall survival.
Results: Of the 36 patients whose medical records were evaluated retrospectively, 24 patients who were eligible for the study were included in the study. Gemcitabine plus docetaxel combination chemotherapy was the most commonly used treatment protocol (n=12, 50%) for first-line palliative treatment. While a complete response as a first-line treatment response could not be achieved, clinical benefit (partial remission and stable disease) and progressive disease were observed in 15 (62%) and 9 (37.5%) patients, respectively. Binary logistic regression analysis failed to detect any independent predictive factors for the clinical benefit of first-line palliative therapy. Median (OS) was 19.7 (95% CI, 4.1-35.3) months for all patients (N=24). Median OS was 25.6 (95% CI, 21.0-30.2) months and 6.9 (95% CI, 1.7-12.2) months for patients with and without the clinical benefit of first-line palliative chemotherapy (p=0.004). Cox-regression analysis revealed that increasing age at diagnosis of metastatic disease (HR=0.929, 95% CI 0.870-0.992, p=0.027), pulmonary metastasectomy (HR=0.162, 95%CI 0.031-0.863, p=0.033), and presence of first-line palliative chemotherapy clinical benefit (HR=0.195, 95% CI 0.063-0.606, p=0.005) were independent predictive factors for a better OS.
Conclusion: In metastatic ULMS, for which the survival benefit is not clear with palliative chemotherapy, prolonged survival can be obtained in patients with clinical benefit with first-line palliative chemotherapy. There is a need for new studies to determine the factors that will predict the clinical benefit of first-line palliative chemotherapy.

References

  • D’Angelo E, Prat J. Uterine sarcomas: a review. Gynecol Oncol 2010; 116: 131-9.
  • Society AC. Cancer facts & figures 2018. Atlanta, GA2018.
  • Ricci S, Stone RL, Fader AN. Uterine leiomyosarcoma: Epidemiology, contemporary treatment strategies and the impact of uterine morcellation. Gynecol Oncol 2017; 145: 208-16.
  • Ganjoo KN. Uterine sarcomas. Curr Probl Cancer 2019; 43: 283-8.
  • Giuntoli RL, 2nd, Metzinger DS, DiMarco CS, et al. Retrospective review of 208 patients with leiomyosarcoma of the uterus: prognostic indicators, surgical management, and adjuvant therapy. Gynecol Oncol 2003; 89: 460-9.
  • Kapp DS, Shin JY, Chan JK. Prognostic factors and survival in 1396 patients with uterine leiomyosarcomas: emphasis on impact of lymphadenectomy and oophorectomy. Cancer. 2008; 112: 820-30.
  • Kanjeekal S, Chambers A, Fung MF, Verma S. Systemic therapy for advanced uterine sarcoma: a systematic review of the literature. Gynecol Oncol 2005; 97: 624-37.
  • Li J, Chen X, Hu X. High-intensity focused ultrasound for treatment of recurrent uterine leiomyosarcoma: a case report and literature review. J Int Med Res 2020; 48: 300060520942107.
  • Maki RG, Wathen JK, Patel SR, et al. Randomized phase II study of gemcitabine and docetaxel compared with gemcitabine alone in patients with metastatic soft tissue sarcomas: results of sarcoma alliance for research through collaboration study 002. J Clin Oncol 2007; 25: 2755-63.
  • Toro JR, Travis LB, Wu HJ, Zhu K, Fletcher CD, Devesa SS. Incidence patterns of soft tissue sarcomas, regardless of primary site, in the surveillance, epidemiology and end results program, 1978-2001: An analysis of 26,758 cases. Int J Cancer 2006; 119: 2922-30.
  • Desar IME, Ottevanger PB, Benson C, van der Graaf WTA. Systemic treatment in adult uterine sarcomas. Crit Rev Oncol Hematol 2018; 122: 10-20.
  • Hensley ML, Maki R, Venkatraman E, et al. Gemcitabine and docetaxel in patients with unresectable leiomyosarcoma: results of a phase II trial. J Clin Oncol 2002; 20: 2824-31.
  • Hensley ML, Blessing JA, Mannel R, Rose PG. Fixed-dose rate gemcitabine plus docetaxel as first-line therapy for metastatic uterine leiomyosarcoma: a Gynecologic Oncology Group phase II trial. Gynecol Oncol 2008; 109: 329-34.
  • Seagle BL, Sobecki-Rausch J, Strohl AE, Shilpi A, Grace A, Shahabi S. Prognosis and treatment of uterine leiomyosarcoma: A National Cancer Database study. Gynecol Oncol 2017; 145: 61-70.
  • Judson I, Verweij J, Gelderblom H, et al. Doxorubicin alone versus intensified doxorubicin plus ifosfamide for first-line treatment of advanced or metastatic soft-tissue sarcoma: a randomised controlled phase 3 trial. Lancet Oncol 2014; 15: 415-23.
  • Seddon B, Strauss SJ, Whelan J, et al. Gemcitabine and docetaxel versus doxorubicin as first-line treatment in previously untreated advanced unresectable or metastatic soft-tissue sarcomas (GeDDiS): a randomised controlled phase 3 trial. Lancet Oncol 2017; 18: 1397-410.
  • Abeler VM, Røyne O, Thoresen S, Danielsen HE, Nesland JM, Kristensen GB. Uterine sarcomas in Norway. A histopathological and prognostic survey of a total population from 1970 to 2000 including 419 patients. Histopathology 2009; 54: 355-64.
  • Mayerhofer K, Obermair A, Windbichler G, et al. Leiomyosarcoma of the uterus: a clinicopathologic multicenter study of 71 cases. Gynecol Oncol 1999; 74: 196-201.
  • Bernstein-Molho R, Grisaro D, Soyfer V, Safra T, Merimsky O. Metastatic uterine leiomyosarcomas: a single-institution experience. Int J Gynecol Cancer 2010; 20: 255-60.
  • Giuntoli RL, 2nd, Garrett-Mayer E, Bristow RE, Gostout BS. Secondary cytoreduction in the management of recurrent uterine leiomyosarcoma. Gynecol Oncol 2007; 106: 82-8.
There are 20 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Article
Authors

Emrah Eraslan 0000-0003-2497-5913

Ayşegül İlhan 0000-0002-0333-1388

Fatih Yıldız 0000-0003-2295-7332

Mutlu Doğan This is me 0000-0001-9359-3770

Publication Date September 24, 2021
Published in Issue Year 2021 Volume: 4 Issue: 6

Cite

AMA Eraslan E, İlhan A, Yıldız F, Doğan M. First-line palliative chemotherapy clinical benefit is a key determinant of survival in metastatic uterine leiomyosarcoma. J Health Sci Med / JHSM. September 2021;4(6):795-799. doi:10.32322/jhsm.963151

Interuniversity Board (UAK) Equivalency: Article published in Ulakbim TR Index journal [10 POINTS], and Article published in other (excuding 1a, b, c) international indexed journal (1d) [5 POINTS].

The Directories (indexes) and Platforms we are included in are at the bottom of the page.

Note: Our journal is not WOS indexed and therefore is not classified as Q.

You can download Council of Higher Education (CoHG) [Yüksek Öğretim Kurumu (YÖK)] Criteria) decisions about predatory/questionable journals and the author's clarification text and journal charge policy from your browser. https://dergipark.org.tr/tr/journal/2316/file/4905/show







The indexes of the journal are ULAKBİM TR Dizin, Index Copernicus, ICI World of Journals, DOAJ, Directory of Research Journals Indexing (DRJI), General Impact Factor, ASOS Index, WorldCat (OCLC), MIAR, EuroPub, OpenAIRE, Türkiye Citation Index, Türk Medline Index, InfoBase Index, Scilit, etc.

       images?q=tbn:ANd9GcRB9r6zRLDl0Pz7om2DQkiTQXqDtuq64Eb1Qg&usqp=CAU

500px-WorldCat_logo.svg.png

atifdizini.png

logo_world_of_journals_no_margin.png

images?q=tbn%3AANd9GcTNpvUjQ4Ffc6uQBqMQrqYMR53c7bRqD9rohCINkko0Y1a_hPSn&usqp=CAU

doaj.png  

images?q=tbn:ANd9GcSpOQFsFv3RdX0lIQJC3SwkFIA-CceHin_ujli_JrqBy3A32A_Tx_oMoIZn96EcrpLwTQg&usqp=CAU

ici2.png

asos-index.png

drji.png





The platforms of the journal are Google Scholar, CrossRef (DOI), ResearchBib, Open Access, COPE, ICMJE, NCBI, ORCID, Creative Commons, etc.

COPE-logo-300x199.jpgimages?q=tbn:ANd9GcQR6_qdgvxMP9owgnYzJ1M6CS_XzR_d7orTjA&usqp=CAU

icmje_1_orig.png

cc.logo.large.png

ncbi.pngimages?q=tbn:ANd9GcRBcJw8ia8S9TI4Fun5vj3HPzEcEKIvF_jtnw&usqp=CAU

ORCID_logo.png

1*mvsP194Golg0Dmo2rjJ-oQ.jpeg


Our Journal using the DergiPark system indexed are;

Ulakbim TR Dizin,  Index Copernicus, ICI World of JournalsDirectory of Research Journals Indexing (DRJI), General Impact FactorASOS Index, OpenAIRE, MIAR,  EuroPub, WorldCat (OCLC)DOAJ,  Türkiye Citation Index, Türk Medline Index, InfoBase Index


Our Journal using the DergiPark system platforms are;

Google, Google Scholar, CrossRef (DOI), ResearchBib, ICJME, COPE, NCBI, ORCID, Creative Commons, Open Access, and etc.


Journal articles are evaluated as "Double-Blind Peer Review". 

Our journal has adopted the Open Access Policy and articles in JHSM are Open Access and fully comply with Open Access instructions. All articles in the system can be accessed and read without a journal user.  https//dergipark.org.tr/tr/pub/jhsm/page/9535

Journal charge policy   https://dergipark.org.tr/tr/pub/jhsm/page/10912


Editor List for 2022

Assoc. Prof. Alpaslan TANOĞLU (MD)  

Prof. Aydın ÇİFCİ (MD)

Prof. İbrahim Celalaettin HAZNEDAROĞLU (MD)

Prof. Murat KEKİLLİ (MD)

Prof. Yavuz BEYAZIT (MD) 

Prof. Ekrem ÜNAL (MD)

Prof. Ahmet EKEN (MD)

Assoc. Prof. Ercan YUVANÇ (MD)

Assoc. Prof. Bekir UÇAN (MD) 

Assoc. Prof. Mehmet Sinan DAL (MD)


Our journal has been indexed in DOAJ as of May 18, 2020.

Our journal has been indexed in TR-Dizin as of March 12, 2021.


17873

Articles published in the Journal of Health Sciences and Medicine have open access and are licensed under the Creative Commons CC BY-NC-ND 4.0 International License.