Impact of Chemotherapy in the Adjuvant Setting of Early Stage Uterine Leiomyosarcoma: A Systematic Review and Updated Meta-Analysis
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-...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-07-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/12/7/1899 |
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| author | Alessandro Rizzo Margherita Nannini Annalisa Astolfi Valentina Indio Pierandrea De Iaco Anna Myriam Perrone Antonio De Leo Lorena Incorvaia Valerio Di Scioscio Maria Abbondanza Pantaleo |
| author_facet | Alessandro Rizzo Margherita Nannini Annalisa Astolfi Valentina Indio Pierandrea De Iaco Anna Myriam Perrone Antonio De Leo Lorena Incorvaia Valerio Di Scioscio Maria Abbondanza Pantaleo |
| author_sort | Alessandro Rizzo |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-10T18:29:48Z |
| format | Article |
| id | doaj.art-9041c50e21b0481d87b874c3638008b7 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T18:29:48Z |
| publishDate | 2020-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-9041c50e21b0481d87b874c3638008b72023-11-20T06:45:24ZengMDPI AGCancers2072-66942020-07-01127189910.3390/cancers12071899Impact of Chemotherapy in the Adjuvant Setting of Early Stage Uterine Leiomyosarcoma: A Systematic Review and Updated Meta-AnalysisAlessandro Rizzo0Margherita Nannini1Annalisa Astolfi2Valentina Indio3Pierandrea De Iaco4Anna Myriam Perrone5Antonio De Leo6Lorena Incorvaia7Valerio Di Scioscio8Maria Abbondanza Pantaleo9Department of Experimental, Diagnostic and Specialty Medicine, S.Orsola-Malpighi Hospital, University of Bologna, 40128 Bologna, ItalyMedical Oncology Unit, S.Orsola-Malpighi University Hospital, 40128 Bologna, ItalyDepartment of Morphology, Surgery and Experimental Medicine, University of Ferrara, 44121 Ferrara, Italy“Giorgio Prodi” Cancer Research Center, University of Bologna, 40128 Bologna, ItalyGynecologic Oncology Unit, S.Orsola-Malpighi University Hospital, 40128 Bologna, ItalyGynecologic Oncology Unit, S.Orsola-Malpighi University Hospital, 40128 Bologna, ItalyPathology Unit, S.Orsola-Malpighi University Hospital, 40128 Bologna, ItalyDepartment of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, Palermo University Hospital, 90100 Palermo, ItalyRadiology Unit, S.Orsola-Malpighi University Hospital, 40128 Bologna, ItalyDepartment of Experimental, Diagnostic and Specialty Medicine, S.Orsola-Malpighi Hospital, University of Bologna, 40128 Bologna, ItalyBackground: 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.https://www.mdpi.com/2072-6694/12/7/1899meta-analysisuterine leiomyosarcomauterine sarcomaadjuvant therapychemotherapy |
| spellingShingle | Alessandro Rizzo Margherita Nannini Annalisa Astolfi Valentina Indio Pierandrea De Iaco Anna Myriam Perrone Antonio De Leo Lorena Incorvaia Valerio Di Scioscio Maria Abbondanza Pantaleo Impact of Chemotherapy in the Adjuvant Setting of Early Stage Uterine Leiomyosarcoma: A Systematic Review and Updated Meta-Analysis Cancers meta-analysis uterine leiomyosarcoma uterine sarcoma adjuvant therapy chemotherapy |
| title | Impact of Chemotherapy in the Adjuvant Setting of Early Stage Uterine Leiomyosarcoma: A Systematic Review and Updated Meta-Analysis |
| title_full | Impact of Chemotherapy in the Adjuvant Setting of Early Stage Uterine Leiomyosarcoma: A Systematic Review and Updated Meta-Analysis |
| title_fullStr | Impact of Chemotherapy in the Adjuvant Setting of Early Stage Uterine Leiomyosarcoma: A Systematic Review and Updated Meta-Analysis |
| title_full_unstemmed | Impact of Chemotherapy in the Adjuvant Setting of Early Stage Uterine Leiomyosarcoma: A Systematic Review and Updated Meta-Analysis |
| title_short | Impact of Chemotherapy in the Adjuvant Setting of Early Stage Uterine Leiomyosarcoma: A Systematic Review and Updated Meta-Analysis |
| title_sort | impact of chemotherapy in the adjuvant setting of early stage uterine leiomyosarcoma a systematic review and updated meta analysis |
| topic | meta-analysis uterine leiomyosarcoma uterine sarcoma adjuvant therapy chemotherapy |
| url | https://www.mdpi.com/2072-6694/12/7/1899 |
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