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Tytuł:
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Efficacy of adjuvant chemotherapy in early stage uterine leiomyosarcoma: A systematic review and meta-analysis.
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Autorzy:
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Bogani G; Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy. Electronic address: .
Fucà G; Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
Maltese G; Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
Ditto A; Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
Martinelli F; Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
Signorelli M; Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
Chiappa V; Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
Scaffa C; Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
Sabatucci I; Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
Lecce F; Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
Raspagliesi F; Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
Lorusso D; Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
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Źródło:
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Gynecologic oncology [Gynecol Oncol] 2016 Nov; Vol. 143 (2), pp. 443-447. Date of Electronic Publication: 2016 Jul 29.
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Typ publikacji:
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Journal Article; Meta-Analysis; Review; Systematic Review
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Język:
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English
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Imprint Name(s):
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Original Publication: New York, Academic Press.
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MeSH Terms:
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Leiomyosarcoma/*drug therapy
Uterine Neoplasms/*drug therapy
Chemotherapy, Adjuvant ; Female ; Humans ; Leiomyosarcoma/pathology ; Neoplasm Staging ; Uterine Neoplasms/pathology
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Contributed Indexing:
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Keywords: Adjuvant; Chemotherapy; Radiotherapy; Survival; Uterine leiomyosarcoma
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Entry Date(s):
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Date Created: 20160803 Date Completed: 20170512 Latest Revision: 20220408
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Update Code:
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20240104
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DOI:
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10.1016/j.ygyno.2016.07.110
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PMID:
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27481579
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Objective: We sought to review the current evidence in order to test the efficacy of adjuvant chemotherapy in improving disease-free survival in patients affected by early stage uterine leiomyosarcoma.
Methods: On July 2016, literature was searched in order to identify trials comparing different postoperative adjuvant strategies for patients diagnosed with early stage uterine leiomyosarcoma.
Results: Our analysis included 360 patients: 145 (40%), 53 (15%), and 155 (43%) had chemotherapy (with or without radiotherapy), radiotherapy, and observation, respectively. Seven (2%) patients who had radiotherapy with or without chemotherapy were excluded from further analysis in order to reduce risk of biases. Administration of chemotherapy (with or without radiotherapy) did not improve outcomes in comparison to observation (OR: 0.79 (95%CI: 0.48, 1.29)), or radiotherapy (OR: 0.90 (95%CI: 0.42, 1.94)). Loco-regional recurrence rate was similar comparing patients undergoing chemotherapy (with or without radiotherapy) with having observation alone (OR: 0.84 (95%CI: 0.44, 1.60)). Similarly, pooled results suggested that chemotherapy administration did not affect distant recurrence rate in comparison to no chemotherapy (OR: 0.80 (95%CI: 0.50, 1.28)), and observation alone (OR: 0.99 (95%CI: 0.60, 1.64)). However, patients undergoing chemotherapy (with or without radiotherapy) experienced a trend towards lower risk of developing distant recurrences (OR: 0.49 (95%CI: 0.24, 1.03)) and a higher risk of developing loco-regional recurrences (OR: 3.45 (95%CI: 1.02, 11.73)) than patients undergoing radiotherapy.
Conclusions: In early stage uterine leiomyosarcoma, the role of adjuvant chemotherapy remains unclear. Owing to the high recurrence rate, even in the early stage of disease, further innovative therapeutic strategies have to be tested.
(Copyright © 2016 Elsevier Inc. All rights reserved.)