The Need for Effective Adjuvant Therapy in Uterine Leiomyosarcoma: A Single-centre Experience.

ABSTRACT

OBJECTIVE: To evaluate the efficacy of adjuvant chemotherapy (ACTx) in completely resected uterine leiomyosarcoma (ULMS) in terms of survival outcomes. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY Department of Medical Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey from February 2009 to November 2019. METHODOLOGY: Patients older than 18 years, who underwent complete surgical resection with a diagnosis of non-metastatic ULMS were evaluated retrospectively. The patients were divided into two groups patients who received ACTx (group I) and patients who received only surgical treatment (group II). Both groups were compared in terms of main patient and tumour characteristics, relapse rates, relapse-free survival (RFS) and overall survival (OS). RESULTS: Forty-five patients with a median age of 52.1 years (IQR, 45.8-58.2) were included in the study. Group I consisted of 26 (57.8%) patients and group II consisted of 19 (42.2%) patients. Median RFS was 43.8 months (95% CI, 7.4-80.2) and the median OS was 81.3 months (95% CI, 39.4-123.1) for all patients (N = 45). Median RFS was 27.1 months (95% CI, 6.8-47.4) in group I (n = 26) and 43.8 months (95% CI, 11.8-75.8) in group II (n = 19) (p = 0.985). Median OS was 85.6 months (95% CI, 38.3-132.9) in group I (n = 26) and 81.2 months (95% CI, 62.1-100.4) in group II (n = 19) (p = 0.699).  Conclusion: There was no survival benefit of ACTx in completely resected ULMSs, in accordance with the literature data. There is a need for prospective randomised clinical trials evaluating the role of ACTx in ULMSs. Key Words Uterine leiomyosarcoma, Complete resection, Adjuvant chemotherapy, Relapse, RFS, OS.