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


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).


CONCLUSIONS
In our analysis, combined regimens did not improve the outcome. Maintenance of the doxorubicin dose was associated with improved PFS. Metastasectomy favorably influenced OS.
Penel
N
N
General Oncology Department, Centre Oscar Lambret, Lille; Equipe d'Accueil 2694: Santé Publique, Epidemiologie des maladies chroniques, University of Lille II, Lille. Electronic address: n-penel@o-lambret.fr.
Italiano
A
A
Department of Medical Oncology, Institut Bergonié, Bordeaux.
Isambert
N
N
Centre d'Investigation Clinique, University of Dijon; Department of Medical Oncology, Centre George-François Leclerc, Dijon.
Bompas
E
E
Department of Medical Oncology, Centre René Gauducheau, Nantes.
Bousquet
G
G
Department of Medical Oncology, Hôpital Saint-Louis, Paris.
Duffaud
F
F
Department of Medical Oncology, CHU La Timone, APHM, Marseille, France.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D004317:Doxorubicin / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007890:Leiomyosarcoma / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012983:Soft Tissue Neoplasms / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D016019:Survival Analysis; D016896:Treatment Outcome
D004317:Doxorubicin