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Steed H, Manchul L, Rosen B, Fyles A, Lockwood G, Laframboise S, Murphy J, Milosevic M, Chapman W, Oza AM. Uterine papillary serous carcinoma: evaluation of multimodality treatment with abdominopelvic radiotherapy and chemotherapy. Int J Gynecol Cancer 2006; 16(Suppl. 1):278–285. The aim of this study was to compare overall survival (OS), progression-free survival (PFS), and relapse patterns between different modalities of treatment for uterine papillary serous carcinoma (UPSC). A retrospective review of 124 patients with pathologically confirmed UPSC was performed, of whom, 97 patients were eligible for study. Postoperative treatment groups included adjuvant radiotherapy consisting of whole abdomen and a pelvic boost (abdominopelvic radiotherapy [APRT]) (55 patients), paclitaxel and carboplatin chemotherapy (CT) for six cycles followed by APRT (18 patients), CT only (5 patients), and 19 patients were observed without postoperative adjuvant therapy. Three-year OS was 81% and 63% for the CT followed by APRT and APRT alone, respectively ( P= 0.11). After controlling for stage, the group treated with APRT alone had significantly decreased OS and PFS compared to the CT/APRT group (HR 3.6; 1.3–9.8; P= 0.01) and (HR 2.9; 95% CI 1.1–7.3; P= 0.03), respectively. Within the limitations of a retrospective study, the results of this study indicate that multimodality postoperative treatment with paclitaxel and a platinum-based CT followed by APRT may increase the survival of patients with UPSC. However, further prospective studies using these combined modalities are needed to confirm these findings. [ABSTRACT FROM AUTHOR]

Steed H, Oza AM, Murphy J, Laframboise S, Lockwood G, De Petrillo D, Sturgeon J, Rosen B. A retrospective analysis of neoadjuvant platinum-based chemotherapy versus up-front surgery in advanced ovarian cancer. Int J Gynecol Cancer 2006; 16(Suppl. 1):47–53. The objective of this study is to compare progression-free survival (PFS) and overall survival (OS) of ovarian cancer patients treated with neoadjuvant chemotherapy and surgery to primary surgery and postoperative chemotherapy. Retrospective analysis from 1998 to 2003 of 116 patients with ovarian cancer was performed. Fifty women diagnosed by positive cytology received three cycles of carboplatin and paclitaxel. Thirty-six patients subsequently underwent cytoreductive surgery and completed three further cycles postoperatively. The OS and PFS were compared in 66 women treated with primary surgery and postoperative chemotherapy. A statistically significant difference was observed for OS ( P= 0.03, HR = 1.85, CI = 1.06–3.23) and PFS ( P= 0.04, HR = 1.61, CI = 1.03–2.53) favoring the primary surgery group. Due to the small numbers, age, grade, stage, pleural effusions, and histologic cell type were controlled for separately in the bivariate analyses. Controlling for stage made the results weaker. A matched subgroup survival analysis was performed on patients who had surgery following neoadjuvant chemotherapy. After matching for stage and grade and controlling age and pleural effusions ( N= 28 matched pairs), there was no statistical difference for OS ( P= 0.95, HR = 1.04, CI = 0.33–3.30) or PFS ( P= 0.79, HR = 1.11, CI = 0.98–1.04). It is concluded that primary surgery should be considered in all patients. Neoadjuvant chemotherapy may be an alternative in a subset of women with the intent to also perform interval debulking. [ABSTRACT FROM AUTHOR]