Abstract
16561 Background: The aim of this study was to describe clinical and pathologic characteristics of patients with MMMT of the uterus who were all treated at a single institution. In addition, we were interested in examining how these features correlated with 5 year OS. Methods: Patients diagnosed with FIGO Stage I-IV MMMT between 1993 and 2007 were identified. Clinical, pathologic and outcome data was obtained from the medical record. Median survival determinations and factors predictive of outcome were compared using the log-rank test. Results: MMMT was identified in 43 patients. The median age of diagnosis was 70 years (range 45–91). Personal history of breast cancer was present in 33% of our patients (62% with history of tamoxifen use). There were 19 stage I patients (IA - 5, IB - 10, IC - 4), 1 stage II patients, 14 stage III patients (IIIA - 4, IIIB - 3, IIIC - 7) and 9 stage IV patients. OS among all patients was 17.2% and the median OS was 36.6 months. Among the stage I patients, the OS was 36% (median - 52 months). The OS in stage III patients was 0% (median - 17 months). The OS in stage IV patients was 0% (median - 3 months). Pathologic features predictive of a worse OS included lymph vascular invasion (p=0.04), deep myometrial invasion (p=0.02), and cervical involvement (p=0.01). Within the group of patients with stage I-III disease (n=34), 47% (n=16) received adjuvant PBCTX and 59% (n=20) received whole pelvic radiation (WPRT). 29% (n=10) received combination PBCTX and WPRT. The OS for those patients who received adjuvant PBCTX was 26% (median - 51 months). The OS for stage I patients who received PBCTX was 38% (median - 52 months) and the OS for stage III patients was 0% (median - 46 months). There was a trend towards an improved survival in the stage III patients who received adjuvant chemotherapy (p=0.07). Conclusions: In our population of non-selected patients with MMMT, 33% had a personal history of breast cancer. Tamoxifen use was common among those patients with breast cancer. Stage, myometrial invasion, lymph vascular invasion, and cervical involvement were all risk factors for a worse prognosis. Adjuvant PBCTX was associated with a favorable OS in our patients. Clinical trials evaluating the role of platinum-based therapy in patients with MMMT are ongoing. No significant financial relationships to disclose.
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