Impact of cytoreductive surgery on survival of patients with low-grade serous ovarian carcinoma: A multicentric study of Turkish Society of Gynecologic Oncology (TRSGO-OvCa-001).

BACKGROUND AND OBJECTIVES: The aim of this study was to analyze the factors affecting recurrence-free (RFS) and overall survival (OS) rates of women diagnosed with low-grade serous ovarian cancer (LGSOC). METHODS: Databases from 13 participating centers in Turkey were searched retrospectively for women who had been treated for stage I-IV LGSOC between 1997 and 2018. RESULTS: Overall 191 eligible women were included. The median age at diagnosis was 49 years (range, 21-84 years). One hundred seventy-five (92%) patients underwent primary cytoreductive surgery. Complete and optimal cytoreduction was achieved in 148 (77.5%) and 33 (17.3%) patients, respectively. The median follow-up period was 44 months (range, 2-208 months). Multivariate analysis showed the presence of endometriosis (p = .012), lymphovascular space invasion (LVSI) (p = .022), any residual disease (p = .023), and the International Federation of Gynecology and Obstetrics (FIGO) stage II-IV disease (p = .045) were negatively correlated with RFS while the only presence of residual disease (p = .002) and FIGO stage II-IV disease (p = .003) significantly decreased OS. CONCLUSIONS: The maximal surgical effort is warranted for complete cytoreduction as achieving no residual disease is the single most important variable affecting the survival of patients with LGSOC. The prognostic role of LVSI and endometriosis should be evaluated by further studies as both of these parameters significantly affected RFS.

Prognostic factors and survival outcomes of women with uterine leiomyosarcoma: A Turkish Uterine Sarcoma Group Study-003.

To assess the clinicopathological features, prognostic factors, and survival rates associated with uterine leiomyosarcoma (uLMS). Databases from 15 participating gynecological oncology centers in Turkey were searched retrospectively for women who had been treated for stage I-IV uLMS between 1996 and 2018. Of 302 consecutive women with uLMS, there were 234 patients with Federation of Gynecology and Obstetrics (FIGO) stage I disease and 68 with FIGO stage II-IV disease. All patients underwent total hysterectomy. Lymphadenectomy was performed in 161 (54.5%) cases. A total of 195 patients received adjuvant treatment. The 5-year disease-free survival (DFS) and overall survival (OS) rates were 42% and 54%, respectively. Presence of lymphovascular space invasion (LVSI), higher degree of nuclear atypia, and absence of lymphadenectomy were negatively correlated with DFS, while LVSI, mitotic count, higher degree of nuclear atypia, FIGO stage II-IV disease, and suboptimal surgery significantly decreased OS. LVSI and higher degree of nuclear atypia appear to be prognostic indicators for uLMS. Lymphadenectomy seems to have a significant effect on DFS but not on OS.

Efficacy of Pazopanib in patients with metastatic uterine sarcoma: A multi-institutional study.

PURPOSE: Uterine sarcoma accounts for 3-9% of uterine malignant tumors and has poor prognosis. Pazopanib is an oral multi-kinase inhibitor and the only tyrosine kinase inhibitor which has been approved for metastatic soft tissue sarcoma. In the present study we aimed to evaluate the efficacy of pazopanib in metastatic uterine sarcoma. METHODS: The data of 28 metastatic uterine sarcoma patients receiving pazopanib therapy, who were followed in four oncology centers in Ankara, Turkey between May 2013 and June 2018, were retrospectively analyzed. Patients over 18 years, ECOG performance status ≤ 2, receiving at least one line of chemotherapy for metastatic disease, measurable disease at diagnosis, and histologically proven uterine high grade sarcoma were the inclusion criteria. Progression-free survival (PFS), overall survival (OS), and response rates to pazopanib were retrospectively evaluated. RESULTS: The median age was 53 years (range, 26-76). The majority of the patients had uterine leiomyosarcoma (LMS) (n=25, 89.3%), 2 (7.1%) had undifferentiated uterine sarcoma (UUS), and 1(3.6%) had high grade endometrial stromal sarcoma (ESS). The most common site of metastasis was lung (n: 21, 75%). The median time for pazopanib therapy was 5 months (0.6-28.3). In 22 patients (78.5%), pazopanib was discontinued due to disease progression, while 2 patients (7.1%) quitted therapy owing to toxicity. Partial response was achieved in 4 patients (14.3%), while 17 (60.7%) had stable disease. Median PFS was 5.2 months (95% CI 2.8-7.5) and median OS was 11.4 months (95% CI 3.4-19.5). CONCLUSION: In the present study aiming to assess the real-life outcome of pazopanib-treated patients, we found that pazopanib is efficient in metastatic uterine sarcoma, and our results correspond to the literature.