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Annals of Oncology Advance Access published online on October 30, 2009
Annals of Oncology, doi:10.1093/annonc/mdp485
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© The Author 2009. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

Factors affecting the outcome of patients with metastatic leiomyosarcoma treated with doxorubicin-containing chemotherapy

N. Penel1,2,*, A. Italiano3, N. Isambert4,5, E. Bompas6, G. Bousquet7, F. Duffaud8 and on behalf of the French Sarcoma Group (Groupe Sarcome Français/Groupe d'Etude des Tumeurs Osseuses)

1 General Oncology Department, Centre Oscar Lambret, Lille
2 Equipe d'Accueil 2694: Santé Publique, Epidemiologie des maladies chroniques, University of Lille II, Lille
3 Department of Medical Oncology, Institut Bergonié, Bordeaux
4 Centre d'Investigation Clinique, University of Dijon
5 Department of Medical Oncology, Centre George-François Leclerc, Dijon
6 Department of Medical Oncology, Centre René Gauducheau, Nantes
7 Department of Medical Oncology, Hôpital Saint-Louis, Paris
8 Department of Medical Oncology, CHU La Timone, APHM, Marseille, France

* Correspondence to: Dr N. Penel, General Oncology Department, Centre Oscar Lambret, 3, rue F Combemale, 59020 Lille, France. Tel: +33-(0)3-20-29-59-20; Fax: +33-(0)3-20-29-59-63; E-mail: n-penel{at}o-lambret.fr

Background: To determine whether pulmonary metastasectomy or the addition of ifosfamide/dacarbazine to a doxorubicin-containing regimen offers a survival benefit to adult patients with metastatic leiomyosarcoma.

Patients and methods: We retrospectively collected data from 147 patients treated with a doxorubicin-containing regimen from 1998 to 2008.

Results: Progression-free survival (PFS) was 6.5 months (range 1–141 months). We did not identify an independent prognostic factor for PFS. Planned dose of doxorubicin was the sole parameter improving PFS [hazard ratio (HR) = 0.13, P = 0.023]. Overall survival (OS) was 17 months (range 1–115 months). The sole identified prognostic factor for OS was the interval between initial diagnosis and metastatic relapse. After adjustment to this prognostic factor, metastasectomy improved OS (HR = 0.52, P = 0.012) and the addition of ifosfamide seemed to worsen OS (HR = 1.42, P = 0.028).

Conclusion: In our analysis, combined regimens did not improve the outcome. Maintenance of the doxorubicin dose was associated with improved PFS. Metastasectomy favorably influenced OS.

dacarbazine, doxorubicin, ifosfamide, leiomyosarcoma, surgery

Received for publication June 5, 2009. Revision received September 10, 2009. Accepted for publication September 11, 2009.


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