Effect of adjuvant therapy on the prognosis in stage I/II uterine carcinosarcoma: A meta-analysis.

Abstract

To assess the efficacy of adjuvant chemotherapy, radiotherapy, or both following the primary surgery on the progression-free survival and 5-year overall survival in patients with stage I/II uterine carcinosarcoma. A preliminary investigation was conducted using PubMed and Embase databases to identify relevant studies published up to March, 2020. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated by Revman 5.3 software to analysis outcomes. Six retrospective cohort studies were involved in the analysis, including 1516 patients in observation group, 956 patients in chemotherapy group, 750 patients in radiotherapy group, and 1082 patients in raidochemotherapy group. The results indicated that chemotherapy alone (HR=0.59, 95% CI=0.38-0.91, p < 0.05) and radiochemotherapy (HR=0.35, 95% CI: 0.24-0.53, p < 0.001) were associated with improved progression-free survival in patients. Similarly, pooled results suggested chemotherapy (HR=0.49, 95% CI=0.34-0.71, p < 0.001) and radiochemotherapy (HR=0.46, 95% CI=0.29-0.72, p < 0.001) promoted the 5-year overall survival compared with observation. However, radiotherapy alone had no statistical significance in improving progression-free survival (HR=0.80, 95% CI=0.49-1.29, p=0.36) and 5-year overall survival (HR=0.65, 95% CI=0.38-1.12, p=0.12). Chemotherapy and radiochemotherapy appeared to be prognostic beneficial to early-stage uterine carcinosarcoma.