Format

Send to

Choose Destination
Gynecol Oncol. 2017 Dec;147(3):565-571. doi: 10.1016/j.ygyno.2017.10.008. Epub 2017 Oct 20.

Salvage chemotherapy with taxane and platinum for women with recurrent uterine carcinosarcoma.

Author information

1
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, CA, USA. Electronic address: koji.matsuo@med.usc.edu.
2
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Magee-Womens Hospital, University of Pittsburgh, PA, USA.
3
Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.
4
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky, KY, USA.
5
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, CA, USA.
6
Department of Gynecology, Cancer Institute Hospital, Tokyo, Japan.
7
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Albert Einstein College of Medicine, Montefiore Medical Center, NY, USA.
8
The Gynecologic Oncology Center, Mercy Medical Center, Baltimore, MD, USA.
9
Department of Obstetrics and Gynecology, Tottori University, Tottori, Japan.
10
Department of Obstetrics and Gynecology, Kyoto University, Kyoto, Japan.
11
Department of Obstetrics and Gynecology, The University of Tokyo, Tokyo, Japan.
12
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Moffitt Cancer Center, University of South Florida, FL, USA.
13
Department of Obstetrics and Gynecology, Saitama Medical University International Medical Center, Saitama, Japan.
14
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Colorado, CO, USA.
15
Department of Obstetrics and Gynecology, Shizuoka Cancer Center, Shizuoka, Japan.
16
Department of Obstetrics and Gynecology, Tokai University, Kanagawa, Japan.
17
Department of Obstetrics and Gynecology, Tokushima University, Tokushima, Japan.
18
Department of Obstetrics and Gynecology, Niigata University, Niigata, Japan.
19
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Oregon Health & Science University, OR, USA.
20
Department of Obstetrics and Gynecology, Iwate Medical University, Morioka, Japan.
21
Department of Obstetrics and Gynecology, Osaka Rosai Hospital, Osaka, Japan.
22
Department of Obstetrics and Gynecology, Osaka University, Osaka, Japan.
23
Department of Obstetrics and Gynecology, Aichi Medical University, Aichi, Japan.
24
Department of Obstetrics and Gynecology, Kawasaki Medical School, Okayama, Japan.
25
Department of Obstetrics and Gynecology, Kurashiki Medical Center, Okayama, Japan.
26
Department of Obstetrics and Gynecology, Kitano Hospital, Osaka, Japan.
27
Department of Obstetrics and Gynecology, Tohoku University, Miyagi, Japan.

Abstract

OBJECTIVE:

To examine survival after recurrence (SAR) among women with recurrent uterine carcinosarcoma who received a taxane/platinum doublet as the first-line salvage chemotherapy.

METHODS:

We retrospectively examined 148 women with recurrent uterine carcinosarcoma who received salvage chemotherapy within a cohort of 906 uterine carcinosarcomas. An independent association of salvage chemotherapy type and SAR was examined with multivariate analysis.

RESULTS:

There were 71 (48.0%) women who received a taxane/platinum regimen. On univariate analysis, women who received a taxane/platinum doublet had a higher 2-year SAR rate compared to women who received non-taxane/platinum regimens (55.5% versus 34.8%, P<0.001). On multivariate analysis, use of taxane/platinum regimen was independently associated with improved SAR compared to the non-taxane/platinum regimens (adjusted-hazard ratio [HR] 0.56, 95% confidence interval [CI] 0.35 to 0.91, P=0.02). When stratified by disease-free interval, women with a disease-free interval ≥6months who received a taxane/platinum doublet had a higher 2-year SAR rate compared to those who received non-taxane/platinum regimens (61.9% versus 40.0%, HR 0.46, 95% CI 0.28 to 0.75, P=0.002); conversely, in women with a disease-free interval <6months, 2-year SAR rates were similar between the two groups (20.5% versus 18.4%, HR 0.80, 95% CI 0.33 to 1.90, P=0.61). Among women who received a taxane/platinum doublet as adjuvant chemotherapy, re-treatment with taxane/platinum doublet as salvage chemotherapy remained beneficial (2-year SAR rate, 62.1% versus 39.7%, HR 0.40, 95% CI 0.18 to 0.86, P=0.019).

CONCLUSION:

Our study suggests that taxane/platinum doublet may be a more effective chemotherapy regimen compared to other regimens among women with recurrent uterine carcinosarcoma, especially for those who had a disease-free interval of ≥6months.

KEYWORDS:

Chemotherapy; Platinum; Recurrence; Survival outcome; Taxane; Uterine carcinosarcoma

PMID:
29056442
DOI:
10.1016/j.ygyno.2017.10.008
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center