03504nam a22003857a 4500
210217s20212021 xxu||||| |||| 00| 0 eng d
0090-8258
10.1016/j.ygyno.2020.12.032 [doi]
S0090-8258(20)34247-5 [pii]
Ovid MEDLINE(R)
33419612
Surgical and oncologic outcomes of hyperthermic intraperitoneal chemotherapy for uterine leiomyosarcoma: A systematic review of literature. [Review]
Gynecologic Oncology. 2021 Jan 05
Gynecol Oncol. 2021 Jan 05
Gynecologic oncology
2021
FY2021
aheadofprint
2021-02-17
Available online from MWHC library: 1972 - present
CONCLUSION: Effectiveness of CRS-HIPEC for disseminated peritoneal uLMS is yet to be determined. As interpretation of the available data on survival is limited due to small sample sizes or the lack of an active comparator, further study is warranted to examine the safety and survival effect of CRS-HIPEC in disseminated peritoneal uLMS. Copyright (c) 2020 Elsevier Inc. All rights reserved.
METHODS: A comprehensive systematic review of literature was conducted using multiple public search engines, PubMed, Scopus, and the Cochrane Library, in compliance with the PRISMA guidelines. Women with disseminated peritoneal uLMS treated with CRS-HIPEC were analyzed. Perioperative morbidity and mortality rate as well as oncologic outcomes related to CRS-HIPEC were assessed.
OBJECTIVE: To examine the perioperative and survival outcomes in women with disseminated peritoneal uterine leiomyosarcoma (uLMS) who underwent cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).
RESULTS: Ten studies met the inclusion criteria from 2004 to 2020, including 8 case series (n=28) and 2 original articles (n=47). Of the 75 patients, 68 (90.7%) were women with uLMS whereas 7 women were non-uLMS. Of these, 64 (85.3%) had recurrent disease, and 39 (52.0%) received chemotherapy or radiotherapy prior to CRS-HIPEC. The perioperative mortality rate was 4.0% (intraoperative 1.3%, and postoperative 2.7%), and postoperative complications (grade >=3) rate ranged 21.4-22.2%. With regard to HIPEC regimens (n=75), cisplatin was most frequently used (n=55, 73.3%) followed by melphalan (n=17, 22.7%) and others (n=3, 4.0%). Among the two observational studies, the median overall survival after CRS-HIPEC treatment was 29.5-37 months. In one limited comparative effectiveness study (n=13), albeit statistically non-significant CRS-HIPEC was associated with higher progression-free survival versus CRS alone (3-year rates, 71.4% versus 0%, P=0.10). When the HIPEC regimens were compared, melphalan use was associated with decreased uLMS-related mortality compared to a cisplatin-based regimen, but the association was not statistically significant (hazard ratio 0.35, 95% confidence interval 0.04-3.05, P=0.35).
English
IN PROCESS -- NOT YET INDEXED
MedStar Washington Hospital Center
Obstetrics and Gynecology
Journal Article
Review
Yasukawa, Maya
Chang EJ, Matsuo K, Matsuzaki S, Matsuzaki S, Roman LD, Yasukawa M
https://dx.doi.org/10.1016/j.ygyno.2020.12.032
https://dx.doi.org/10.1016/j.ygyno.2020.12.032
ART
Article
0
0
0
0
Article
authcat
authcat
2021-02-17
0
33419612
33419612
2021-02-17
2021-02-17
ART
6065
6065