title: Combined adjuvant cisplatin and ifosfamide chemotherapy and radiotherapy for malignant mixed müllerian tumors of the uterus.
abstract: The role of adjuvant therapy for malignant mixed müllerian tumors of the uterus has not been established. Our aim was to review our experience with sequential adjuvant therapy using cisplatin and ifosfamide chemotherapy and radiotherapy after surgical staging. A retrospective study of 43 patients from 1995 to 2004 was undertaken. Survival was calculated using the Kaplan-Meier method and compared by the log-rank test. The Cox proportional hazard regression model was used to assess the effect of treatment on survival after adjustment for age and stage. Twenty-eight patients received adjuvant chemotherapy and 28 patients had adjuvant radiotherapy. Twenty-one patients underwent sequential adjuvant chemotherapy and radiotherapy. Tumor recurrence occurred in 14 patients at a median duration of 10 months. The overall 2- and 5-year survival was 64% and 60%, respectively. The 2- and 5-year survival for stage I and II diseases was both 95%, while the 2-year survival for stage III and IV diseases was 25%. Patients who underwent sequential adjuvant therapy had an improved survival compared with patients who did not follow the protocol (P= 0.024). Our results with sequential adjuvant therapy are encouraging and justify future randomized trials.
authors.affiliation: KK Women's and Children's Hospital, Singapore. lisawong@doctors.sg
authors.forename: L
authors.initials: L
authors.lastname: Wong
authors.forename: H T
authors.initials: HT
authors.lastname: See
authors.forename: H S
authors.initials: HS
authors.lastname: Khoo-Tan
authors.forename: J S
authors.initials: JS
authors.lastname: Low
authors.forename: W T
authors.initials: WT
authors.lastname: Ng
authors.forename: J J
authors.initials: JJ
authors.lastname: Low
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage*; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D018572:Disease-Free Survival; D004341:Drug Evaluation; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007069:Ifosfamide / Q000008:administration & dosage*; D008875:Middle Aged; D018200:Mixed Tumor, Mullerian / Q000188:drug therapy* / Q000532:radiotherapy*; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D011184:Postoperative Period; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*
chemical_list: D002945:Cisplatin; D007069:Ifosfamide