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

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

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)337-346
Number of pages10
JournalJournal of Obstetrics and Gynaecology Research
Volume46
Issue number2
DOIs
StatePublished - 1 Feb 2020

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Leiomyosarcoma
Gynecology
Obstetrics
Multicenter Studies
Therapeutics
Disease-Free Survival
Survival
Electrocoagulation
Uterus
Multivariate Analysis
Morcellation
Radiation
Neoplasm Metastasis
Recurrence
Drug Therapy
Incidence

Keywords

  • adjuvant treatment
  • leiomyosarcoma
  • prognosis
  • recurrence
  • survival
  • uterine neoplasms

Cite this

Kim, Se Ik ; Choi, Chel Hun ; Kim, Kidong ; Hong, Deok Ho ; Park, Jeong Yeol ; Kwon, Byung Su ; Lee, Keun Ho ; Hong, Dae Gy ; Shin, So Jin ; Park, Sang Il ; Kim, Yun Hwan ; Lee, Seung Ho ; Lee, Sanghoon ; Hong, Jin Hwa ; Lee, Jung Yun ; Kim, Yong Beom ; No, Jae Hong ; Suh, Dong Hoon. / Effectiveness of adjuvant treatment for morcellated, International Federation of Gynecology and Obstetrics stage I uterine leiomyosarcoma : A Korean multicenter study. In: Journal of Obstetrics and Gynaecology Research. 2020 ; Vol. 46, No. 2. pp. 337-346.
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title = "Effectiveness of adjuvant treatment for morcellated, International Federation of Gynecology and Obstetrics stage I uterine leiomyosarcoma: A Korean multicenter study",
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.",
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Effectiveness of adjuvant treatment for morcellated, International Federation of Gynecology and Obstetrics stage I uterine leiomyosarcoma : A Korean multicenter study. / Kim, Se Ik; Choi, Chel Hun; Kim, Kidong; Hong, Deok Ho; Park, Jeong Yeol; Kwon, Byung Su; Lee, Keun Ho; Hong, Dae Gy; Shin, So Jin; Park, Sang Il; Kim, Yun Hwan; Lee, Seung Ho; Lee, Sanghoon; Hong, Jin Hwa; Lee, Jung Yun; Kim, Yong Beom; No, Jae Hong; Suh, Dong Hoon.

In: Journal of Obstetrics and Gynaecology Research, Vol. 46, No. 2, 01.02.2020, p. 337-346.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effectiveness of adjuvant treatment for morcellated, International Federation of Gynecology and Obstetrics stage I uterine leiomyosarcoma

T2 - A Korean multicenter study

AU - Kim, Se Ik

AU - Choi, Chel Hun

AU - Kim, Kidong

AU - Hong, Deok Ho

AU - Park, Jeong Yeol

AU - Kwon, Byung Su

AU - Lee, Keun Ho

AU - Hong, Dae Gy

AU - Shin, So Jin

AU - Park, Sang Il

AU - Kim, Yun Hwan

AU - Lee, Seung Ho

AU - Lee, Sanghoon

AU - Hong, Jin Hwa

AU - Lee, Jung Yun

AU - Kim, Yong Beom

AU - No, Jae Hong

AU - Suh, Dong Hoon

PY - 2020/2/1

Y1 - 2020/2/1

N2 - 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.

AB - 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.

KW - adjuvant treatment

KW - leiomyosarcoma

KW - prognosis

KW - recurrence

KW - survival

KW - uterine neoplasms

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JO - Journal of Obstetrics and Gynaecology Research

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