Impact of Chemotherapy in the Adjuvant Setting of Early Stage Uterine Leiomyosarcoma: A Systematic Review and Updated Meta-Analysis

被引:40
作者
Rizzo, Alessandro [1 ]
Nannini, Margherita [2 ]
Astolfi, Annalisa [3 ]
Indio, Valentina [4 ]
De Iaco, Pierandrea [5 ]
Perrone, Anna Myriam [5 ]
De Leo, Antonio [6 ]
Incorvaia, Lorena [7 ]
Di Scioscio, Valerio [8 ]
Pantaleo, Maria Abbondanza [1 ]
机构
[1] Univ Bologna, S Orsola Malpighi Hosp, Dept Expt Diagnost & Specialty Med, I-40128 Bologna, Italy
[2] S Orsola Malpighi Univ Hosp, Med Oncol Unit, I-40128 Bologna, Italy
[3] Univ Ferrara, Dept Morphol Surg & Expt Med, I-44121 Ferrara, Italy
[4] Univ Bologna, Giorgio Prodi Canc Res Ctr, I-40128 Bologna, Italy
[5] S Orsola Malpighi Univ Hosp, Gynecol Oncol Unit, I-40128 Bologna, Italy
[6] S Orsola Malpighi Univ Hosp, Pathol Unit, I-40128 Bologna, Italy
[7] Palermo Univ Hosp, Dept Surg Oncol & Oral Sci, Sect Med Oncol, I-90100 Palermo, Italy
[8] S Orsola Malpighi Univ Hosp, Radiol Unit, I-40128 Bologna, Italy
关键词
meta-analysis; uterine leiomyosarcoma; uterine sarcoma; adjuvant therapy; chemotherapy; CLINICAL-PRACTICE GUIDELINES; PROGNOSTIC-FACTORS; SOFT-TISSUE; SARCOMA; SURVIVAL; OUTCOMES; MORCELLATION; EXPRESSION; MANAGEMENT; DOCETAXEL;
D O I
10.3390/cancers12071899
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
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.
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页码:1 / 12
页数:12
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