Abstract
Background: Although the use of adjuvant chemotherapy (AC) appears to be increasing over the past few years, several clinical trials and previous meta-analyses failed to determine whether AC could improve clinical outcomes in uterine leiomyosarcoma (uLMS). The aim of this systematic review and meta-analysis was to compare AC (with or without radiotherapy) versus observation (obs) after primary surgery in early stage uLMS. Materials and Methods: Randomized controlled (RCTs) and non-randomized studies (NRSs) were retrieved. Outcomes of interest were as follows: distant recurrence rate, locoregional recurrence rate and overall recurrence rate. Results about distant recurrence rate, locoregional recurrence rate and overall recurrence rate were compared by calculating odds ratios (ORs) with 95% confidence intervals (CIs); ORs were combined with Mantel–Haenszel method. Results: Nine studies were included in the analysis, involving 545 patients (AC: 252, obs: 293). Compared with obs, AC did not reduce locoregional and distant recurrence rate, with a pooled OR of 1.36 and 0.63, respectively. Similarly, administration of AC did not decrease overall recurrence rate in comparison to obs. Conclusion: According to our results, AC (with or without radiotherapy) did not decrease recurrence rate in early stage uLMS; thus, the role of AC in this setting remains unclear.
Highlights
Uterine leiomyosarcoma is a rare tumor accounting for approximately 2% of all uterine malignancies and 65% of all uterine sarcomas, with an estimated incidence of 0.60 per 100.000 women/year [1,2,3,4,5]
All clinical trials published from June 15, 1985 to March 29, 2020, which evaluated the effect of adjuvant chemotherapy in completely resected early stage uterine leiomyosarcoma (uLMS) were independently searched in PubMed/ Medline, Cochrane library
Adjuvant treatment in early stage uLMS is a controversial and long-standing issue, given the Adjuvant treatment in early stage uLMS is a controversial and long-standing issue, given the conflicting results achieved in several randomized controlled trials (RCTs) and non-randomized studies (NRSs) while assessing different agents in this setting [2]
Summary
Uterine leiomyosarcoma (uLMS) is a rare tumor accounting for approximately 2% of all uterine malignancies and 65% of all uterine sarcomas, with an estimated incidence of 0.60 per 100.000 women/year [1,2,3,4,5]. The aim of this systematic review and meta-analysis was to compare AC (with or without radiotherapy) versus observation (obs) after primary surgery in early stage uLMS. Outcomes of interest were as follows: distant recurrence rate, locoregional recurrence rate and overall recurrence rate. Results about distant recurrence rate, locoregional recurrence rate and overall recurrence rate were compared by calculating odds ratios (ORs) with 95% confidence intervals (CIs); ORs were combined with Mantel–Haenszel method. AC did not reduce locoregional and distant recurrence rate, with a pooled OR of 1.36 and 0.63, respectively. Administration of AC did not decrease overall recurrence rate in comparison to obs. Conclusion: According to our results, AC (with or without radiotherapy) did not decrease recurrence rate in early stage uLMS; the role of AC in this setting remains unclear
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
