Neoadjuvant chemotherapy in patients with advanced endometrial cancer

Objectives Neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) is a treatment strategy for ovarian cancer patients with unresectable disease or poor performance status (PS). This strategy has been used in the treatment of advanced endometrial cancer and a survival benefit ha...

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Vydáno v:Cancer chemotherapy and pharmacology Ročník 84; číslo 2; s. 281 - 285
Hlavní autoři: Khouri, Olivia R., Frey, Melissa K., Musa, Fernanda, Muggia, Franco, Lee, Jessica, Boyd, Leslie, Curtin, John P., Pothuri, Bhavana
Médium: Journal Article
Jazyk:angličtina
Vydáno: Berlin/Heidelberg Springer Berlin Heidelberg 01.08.2019
Springer Nature B.V
Témata:
Adult
Aged
Aged, 80 and over
Cancer Research
Chemotherapy
Endometrial cancer
Endometrial Neoplasms - drug therapy
Endometrial Neoplasms - pathology
Endometrium
Female
Humans
Medicine
Medicine & Public Health
Middle Aged
Neoadjuvant Therapy - methods
Oncology
Original Article
Ovarian cancer
Patients
Pharmacology/Toxicology
Surgery
Neoadjuvant chemotherapy
Endometrial cancer
Interval debulking
ISSN:0344-5704, 1432-0843, 1432-0843
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Shrnutí:Objectives Neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) is a treatment strategy for ovarian cancer patients with unresectable disease or poor performance status (PS). This strategy has been used in the treatment of advanced endometrial cancer and a survival benefit has been shown in patients who are subsequently able to undergo interval cytoreduction. This study sought to review our single institution experience with NACT for advanced endometrial cancer. Methods We conducted a retrospective review of all patients who received NACT for advanced endometrial cancer at two institutions in New York City between 2002 and 2016. Results We identified 39 patients (median age 61, range 35–89). The histologic subtype distribution was: serous (44%), endometrioid (28%), carcinosarcoma (10%), clear cell (8%), mixed (8%), neuroendocrine (3%). Contraindications to primary surgery included: unresectable disease (72%), poor PS (15%), unresectable disease and poor PS (13%). Twenty-three patients (59%) did not undergo IDS due to: progression of disease (70%), medical ineligibility (4%), unresectable disease (17%), lost to follow-up (4%), death (4%). Sixteen patients (41%) underwent IDS, 81% had an optimal cytoreduction. Disease status at NACT completion was: partial response (56%), stable disease (3%) and progression of disease (41%). There were no complete responses. Patients who responded to NACT had a significantly longer overall survival than those who did not (15 vs. 5 months. P  = 0.015). IDS was also associated with an improvement in overall survival versus no surgery (16 vs. 6 months, P  = 0.04). Conclusions Unlike ovarian cancer, less than half of the patients undergoing NACT for endometrial cancer underwent IDS, none had a complete response, and 41% had disease progression during NACT. However, endometrial cancer patients who underwent IDS had a high rate of optimal cytoreduction. Both response to NACT and IDS were associated with improved survival.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:0344-5704
1432-0843
1432-0843
DOI:10.1007/s00280-019-03838-x