Table 4.
Univariate and multivariate analyses of survival after SCS in patients with uterine sarcoma
| Progression-free survival | Overall survival | |||||||
|---|---|---|---|---|---|---|---|---|
| Univariate | Multivariate | Univariate | Multivariate | |||||
| HR (95%CI) | P value | HR (95%CI) | P value | HR (95%CI) | P value | HR (95%CI) | P value | |
| Age at recurrence (years) | 0.004 | 0.345 | 0.006 | 0.006 | ||||
| < 60 | 1 | 1 | 1 | 1 | ||||
| ≥ 60 | 4.265 (1.572–11.574) | 2.153 (0.438–10.577) | 3.511 (1.424–8.656) | 3.868 (1.469–10.185) | ||||
| ECOG performance status before SCR | 0.031 | 0.237 | 0.069 | |||||
| 0 | 1 | 1 | 1 | |||||
| 1–2 | 3.232 (1.113–9.388) | 3.000 (0.485–18.550) | 2.521 (0.932–6.821) | |||||
| FIGO stage at initial diagnosis | 0.362 | 0.533 | ||||||
| I/II | 1 | 1 | ||||||
| III/IV | 1.575 (0.593–4.183) | 1.408 (0.481–4.122) | ||||||
| Histology | ||||||||
| Uterine leiomyosarcoma | 1 | 1 | ||||||
| Low-grade ESS | 0.566 (0.246–1.299) | 0.179 | 0.610 (0.250–1.491) | 0.279 | ||||
| High-grade ESS | 1.493 (0.430–5.185) | 0.528 | 1.454 (0.415–5.095) | 0.559 | ||||
| Other | 0.645 (0.187–2.222) | 0.487 | 0.615 (0.140–2.693) | 0.518 | ||||
| Clinical symptoms at recurrence | 0.776 | 0.814 | ||||||
| No | 1 | 1 | ||||||
| Symptomatic | 0.905 (0.456–1.797) | 0.915 (0.435–1.924) | ||||||
| Size of largest tumor (cm) | 0.774 | 0.643 | ||||||
| ≤ 6 | 1 | 1 | ||||||
| > 6 | 0.904 (0.455–1.798) | 0.839 (0.398–1.767) | ||||||
| Number of recurrent tumors | 0.016 | 0.532 | 0.036 | 0.925 | ||||
| One | 1 | 1 | 1 | 1 | ||||
| Several | 2.523 (1.187–5.362) | 1.333 (0.541–3.287) | 2.471 (1.063–5.742) | 0.947 (0.308–2.910) | ||||
| DFI before SCS (months) | 0.090 | 0.034 | 0.024 | |||||
| < 12 | 1 | 1 | 1 | |||||
| ≥ 12 | 0.540 (0.265–1.101) | 0.414 (0.183–0.934) | 0.341 (0.134–0.870) | |||||
| Retroperitoneal lymph node metastasis | 0.820 | 0.616 | ||||||
| No | 1 | 1 | ||||||
| Yes | 1.182 (0.280–5.001) | 0.599 (0.081–4.429) | ||||||
| Distant metastasis | 0.601 | 0.842 | ||||||
| No | 1 | 1 | ||||||
| Yes | 0.728 (0.221–2.394) | 1.131 (0.339–3.775) | ||||||
| Peritoneal dissemination | 0.004 | 0.007 | 0.021 | 0.006 | ||||
| No | 1 | 1 | 1 | 1 | ||||
| Yes | 2.926 (1.404–6.096) | 3.118 (1.356–7.169) | 2.458 (1.144–5.282) | 3.672 (1.441–9.361) | ||||
| Ascites | 0.498 | 0.534 | ||||||
| None | 1 | 1 | ||||||
| Yes | 0.662 (0.201–2.184) | 0.633 (0.150–2.675) | ||||||
| Residual disease | 0.002 | 0.026 | 0.017 | 0.789 | ||||
| None | 1 | 1 | 1 | 1 | ||||
| > 0 | 3.239 (1.563–6.711) | 2.662 (1.122–6.319) | 2.531 (1.182–5.421) | 1.138 (0.443–2.924) | ||||
| Adjuvant therapy after SCS | ||||||||
| None | 1 | 1 | ||||||
| Chemotherapy only | 0.753 (0.347–1.634) | 0.472 | 0.652 (0.284–1.495) | 0.312 | ||||
| Radiotherapy only | 0.832 (0.180–3.849) | 0.814 | 0.444 (0.056–3.512) | 0.441 | ||||
| CCRT | 0.338 (0.043–2.677) | 0.304 | 0.562 (0.071–4.458) | 0.586 | ||||
| Hormonal therapy | 0.312 (0.040–2.467) | 0.270 | 0.402 (0.051–3.191) | 0.389 | ||||
| Other | 14.008 (1.211-162.075) | 0.035 | 2.497 (0.297–21.022) | 0.400 | ||||
SCS, Secondary cytoreductive surgery; ECOG, Eastern Cooperative Oncology Group; FIGO, International Federation of Gynecology and Obstetrics; HR, hazard ratio; CI, confidence intervals; ESS, endometrial stromal sarcoma; DFI, Disease-free interval; CCRT, Combined chemoradiotherapy