title: Improved clinical trial enrollments for uterine leiomyosarcoma patients after gynecologic oncology partnership with a sarcoma center.
abstract: OBJECTIVE
  A retrospective chart review was performed to determine patient outcomes before and after partnership by gynecologic oncologists (GYN/ONC) with a sarcoma center (SC) for patients with recurrent unresectable/metastatic (RM) uterine leiomyosarcoma (uLMS).
  
  
  METHODS
  58 RM patients, identified from medical records of uLMS patients cared for by either GYN/ONC service and/or the SC between 1/1/2000-4/1/2014, were audited for patient and tumor characteristics, outcomes, and clinical trials enrollments.
  
  
  RESULTS
  Of the 58 patients, 26 patients (48%) were treated by GYN/ONC alone and 32 were treated by a combination of GYN/ONC and SC (52%). Age, race, tumor size, grade, presence of lymphovascular invasion, cervical involvement, and FIGO stage at diagnosis were not statistically different between the two groups. There was a significant difference between the number of clinical trial enrollments (0.07 vs 0.84 trials/patient, p<0.001) and the number of chemotherapy regimens prescribed (2.67 vs 4.29/patient, p=0.03) by GYN/ONC vs SC; the latter was driven by the number of clinical trial enrollments by the SC. Sixty-nine percent of patients referred to the SC were enrolled in at least one clinical trial, while just 8% of patients in the GYN/ONC group were enrolled in at least one clinical trial, a difference that is significant (p<0.0001).
  
  
  CONCLUSIONS
  Referral of RM uLMS patients by GYN/ONC to a dedicated clinical trials-based SC resulted in an increase in the number of chemotherapy regimens prescribed and clinical trial enrollments. Partnership between GYN/ONC and a dedicated SC with access to clinical trials should be encouraged for all RM uLMS patients.
authors.affiliation: Division of Gynecologic Oncology, Washington University in St. Louis, St. Louis, MO 63110, United States. Electronic address: langes@wudosis.wustl.edu.
authors.forename: S E S
authors.initials: SE
authors.lastname: Lange
authors.affiliation: Division of Public Health Sciences, Washington University in St. Louis, St. Louis, MO 63110, United States.
authors.forename: J
authors.initials: J
authors.lastname: Liu
authors.affiliation: Division of Medical Oncology, Washington University in St. Louis, St. Louis, MO 63110, United States; Siteman Cancer Center, Washington University in St. Louis, St. Louis, MO 63110, United States.
authors.forename: D R
authors.initials: DR
authors.lastname: Adkins
authors.affiliation: Division of Gynecologic Oncology, Washington University in St. Louis, St. Louis, MO 63110, United States; Siteman Cancer Center, Washington University in St. Louis, St. Louis, MO 63110, United States.
authors.forename: M A
authors.initials: MA
authors.lastname: Powell
authors.affiliation: Division of Medical Oncology, Washington University in St. Louis, St. Louis, MO 63110, United States; Siteman Cancer Center, Washington University in St. Louis, St. Louis, MO 63110, United States.
authors.forename: B A
authors.initials: BA
authors.lastname: Van Tine
authors.affiliation: Division of Gynecologic Oncology, Washington University in St. Louis, St. Louis, MO 63110, United States; Siteman Cancer Center, Washington University in St. Louis, St. Louis, MO 63110, United States.
authors.forename: D G
authors.initials: DG
authors.lastname: Mutch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002986:Clinical Trials as Topic / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006176:Gynecology / Q000458:organization & administration*; D006801:Humans; D007890:Leiomyosarcoma / Q000188:drug therapy* / Q000473:pathology; D008495:Medical Oncology / Q000458:organization & administration*; D008875:Middle Aged; D009367:Neoplasm Staging; D018579:Patient Selection; D012189:Retrospective Studies; D015996:Survival Rate; D014594:Uterine Neoplasms / Q000188:drug therapy* / Q000473:pathology
keywords: Clinical trials; Gynecologic oncology; Medical oncology; Overall survival; Sarcoma center; Uterine leiomyosarcoma