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Use and outcomes of neoadjuvant chemotherapy for metastatic uterine cancer.

Publication ,  Journal Article
Wright, JD; Huang, Y; Melamed, A; Albright, BB; Hillyer, GC; Previs, R; Hershman, MSDL
Published in: Gynecol Oncol
September 2021

OBJECTIVE: Neoadjuvant chemotherapy (NACT) has emerged as an alternative to primary cytoreductive surgery (PCS) for stage IV uterine cancer. We examined utilization, perioperative outcomes and survival for NACT and PCS for stage IV uterine cancer. METHODS: The Surveillance, Epidemiology, End Results-Medicare database was used to identify women with stage IV uterine cancer treated from 2000 to 2015. Women were classified as NACT or PCS. Interval cytoreductive surgery (after NACT) or chemotherapy (after PCS) were recorded. The extent of surgery and perioperative outcomes were estimated for the groups. Multivariable proportional hazards models and Kaplan-Meier analyses were used to examine survival. RESULTS: Among 3037 women, 1629 (53.6%) were treated with primary cytoreductive surgery, 554 (18.2%) with NACT, and 854 (28.1%) received no treatment. Use of NACT increased from 9.5% to 29.2%. After NACT, interval hysterectomy was performed in 159 (28.6%), while within the PCS group, 1052 (64.6%) received chemotherapy. Extended cytoreductive procedures were performed in 71.7% of women who received NACT vs. 79.1% after PCS (P = 0.03). The complication rate was 52.8% for NACT versus 56.2% for PCS (P = 0.42); medical complications were more frequently seen in the PCS group (39.4% versus 28.9%; P = 0.01). There was no difference in cancer specific (P = 0.48) or overall survival (P = 0.25) in women who received both chemotherapy and surgery regardless of whether the initial treatment was NACT or PCS. CONCLUSION: Use of NACT is increasing for advanced stage uterine cancer. There was no difference in survival between NACT and primary cytoreductive surgery and NACT was associated with fewer perioperative medical complications.

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Published In

Gynecol Oncol

DOI

EISSN

1095-6859

Publication Date

September 2021

Volume

162

Issue

3

Start / End Page

599 / 605

Location

United States

Related Subject Headings

  • Uterine Neoplasms
  • United States
  • Survival Rate
  • SEER Program
  • Proportional Hazards Models
  • Oncology & Carcinogenesis
  • Neoplasm Metastasis
  • Neoadjuvant Therapy
  • Linear Models
  • Hysterectomy
 

Citation

APA
Chicago
ICMJE
MLA
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Wright, J. D., Huang, Y., Melamed, A., Albright, B. B., Hillyer, G. C., Previs, R., & Hershman, M. S. D. L. (2021). Use and outcomes of neoadjuvant chemotherapy for metastatic uterine cancer. Gynecol Oncol, 162(3), 599–605. https://doi.org/10.1016/j.ygyno.2021.06.016
Wright, Jason D., Yongmei Huang, Alexander Melamed, Benjamin B. Albright, Grace C. Hillyer, Rebecca Previs, and MS Dawn L. Hershman. “Use and outcomes of neoadjuvant chemotherapy for metastatic uterine cancer.Gynecol Oncol 162, no. 3 (September 2021): 599–605. https://doi.org/10.1016/j.ygyno.2021.06.016.
Wright JD, Huang Y, Melamed A, Albright BB, Hillyer GC, Previs R, et al. Use and outcomes of neoadjuvant chemotherapy for metastatic uterine cancer. Gynecol Oncol. 2021 Sep;162(3):599–605.
Wright, Jason D., et al. “Use and outcomes of neoadjuvant chemotherapy for metastatic uterine cancer.Gynecol Oncol, vol. 162, no. 3, Sept. 2021, pp. 599–605. Pubmed, doi:10.1016/j.ygyno.2021.06.016.
Wright JD, Huang Y, Melamed A, Albright BB, Hillyer GC, Previs R, Hershman MSDL. Use and outcomes of neoadjuvant chemotherapy for metastatic uterine cancer. Gynecol Oncol. 2021 Sep;162(3):599–605.
Journal cover image

Published In

Gynecol Oncol

DOI

EISSN

1095-6859

Publication Date

September 2021

Volume

162

Issue

3

Start / End Page

599 / 605

Location

United States

Related Subject Headings

  • Uterine Neoplasms
  • United States
  • Survival Rate
  • SEER Program
  • Proportional Hazards Models
  • Oncology & Carcinogenesis
  • Neoplasm Metastasis
  • Neoadjuvant Therapy
  • Linear Models
  • Hysterectomy