Article Text

Download PDFPDF
#819 Primary results of DAYDREAM study, a real-world multicentre study on the efficacy of adjuvant chemotherapy in high-grade uterine sarcomas
  1. Alejandro Gallego Martínez1,
  2. Nerea Martin-Calvo2,
  3. Mehmet Mutlu Meydanli3,
  4. Ghanim Khatib4,
  5. Dilyara Kaidarova5,
  6. Ali Ayhan6,
  7. Fulvio Borella7,
  8. Marco Sanchez-Salcedo8,
  9. Muzaffer Sanci9,
  10. Claudia Bessa Bessa Pereira Chaves10,
  11. Mervat Ali Mohamed Elsersy11,
  12. Raikhan Bolatbekova12,
  13. George Vorias13,
  14. Antonio Gil-Moreno14,
  15. Anna Myriam Perrone15,
  16. Jagannath Mishra16,
  17. Petra Zusterzeel17,
  18. Vasilis Theodoulidis18,
  19. Igor Aluloski19,
  20. Cornelis DDe Kroon20,
  21. Giuseppe Comerci21,
  22. Tayfun Toptas22,
  23. Robert Fruscio23,
  24. Octavio Arencibia Sanchez24,
  25. Maria De Marino Caba25,
  26. Eva-Maria Niine-Roolah26,
  27. Belen Martin-Salamanca27,
  28. Elena Cabezas López28,
  29. Paolo Scollo29,
  30. Pawel Blecharz30,
  31. Franziska Siegenthaler31,
  32. Mihai Bacila32,
  33. Christine Gennigens33,
  34. Antonio Gonzalez-Martin1 and
  35. Luis Chiva De Agustin34
  1. 1Department of Medical Oncology, Cancer Center Clínica Universidad de Navarra (CCUN), Madrid And Pamplona, Spain
  2. 2Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona, Spain, Pamplona, Spain
  3. 3Medical Point Hospital, Gaziantep, Turkey
  4. 4Cukurova University, Adana, Turkey
  5. 5Kazakh Institute of Oncology and Radiology, Almaty, Kazakhstan
  6. 6Turkish Society of Gynecologic Oncology (TRSGO), Baskent University, Ankara, Turkey
  7. 7SCDU Ginecologia e Ostetricia 1U, Ospedale Sant’Anna, AOU Città della Salute e della Scienza di Torino, Torino, Italy
  8. 8Insituto Nacional de Enfermedades Neoplásicas, Lima, Peru
  9. 9Tepecik Training and Research Hospital, Izmir, Turkey
  10. 10Brazilian National Cancer Institute, Rio De Janeiro, Brazil
  11. 11Gyn-Oncology Unit, El-Shatby Maternity University Hospital, Alexandria, Egypt
  12. 12Almaty Oncology Center, Almaty, Kazakhstan
  13. 13Metaxa Memorial Cancer Hospital, Pireas, Greece
  14. 14Vall Hebron University Hospital, Barcelona, Spain
  15. 15Department of Obstetrics and Gynecology, Unit of Oncologic Gynecology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
  16. 16Tata Medical Center, Kolkata, India
  17. 17Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands
  18. 181st Department of Obstetrics and Gynecology, Thessaloniki, Greece
  19. 19University Clinic for Gynecology and Obstetrics-Skopje, Skopje, Macedonia, Former Yugoslav Republic of
  20. 20Leiden University Medical Center, Leiden, The Netherlands
  21. 21Unit of Gynecological Oncology. S.Maria delle Croci Hospital. AUSL della Romagna., Ravenna., Italy
  22. 22Department of Gynaecological Oncology, Antalya Training and Research Hospital, Saglik Bilimleri University, Antalya, Turkey
  23. 23Clinic of Obstetrics and Gynecology, IRCCS Fondazione San Gerardo dei Tintori, Monza, Italy
  24. 24Complejo Hospitalario Universitario Insular Materno Infantil de Canarias, Las Palmas De Gran Canaria, Spain
  25. 25Hospital Clínico Universitario de Salamanca, Salamanca, Spain
  26. 26North Estonia Medical Centre, Tallin, Estonia
  27. 27Department of Obstetrics and Gynecology, Hospital Universitario de Getafe, Getafe, Spain
  28. 28Ramon y Cajal University Hospital, Madrid, Spain
  29. 29Division of Gynecology and Obstetrics, Cannizzaro Hospital, Catania, Italy
  30. 30Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, CEEGOG, Cracow, Poland
  31. 31Department of Obstetrics and Gynecology, Bern University Hospital and University of Bern, Bern, Switzerland
  32. 32Municipal Hospital Timisoara, Timisoara, Romania
  33. 33Department of Medical Oncoloy, University Hospital (CHU) of Liège, Liège, Belgium
  34. 34Department of Gynecology and Obstetrics, Cancer Center Clínica Universidad de Navarra (CCUN), Madrid And Pamplona, Spain


Introduction/Background High-grade uterine sarcoma (HGUS) is a rare disease. Treatment consists of surgery, but even patients with early-stages are at high risk of recurrence. Although the benefit of adjuvant chemotherapy (AC) is uncertain, and prospective data are very limited, AC use is increasing.

Methodology Daydream is a multicentre, observational study, in patients with surgically resected FIGO stages I to IV HGUS with or without AC from 2013 to 2018. The primary endpoint is OS.

We selected potential prognostic variables based on previous evidence and performed inverse probability weighting to establish two homogeneous groups regarding the use of AC. A risk stratification into 3 groups (high, medium and low) was defined based on baseline variables associated with an increased risk of death in the multivariate analysis (p<0.05). We performed a proportional hazard Cox regression to calculate the HR of death associated to the use of AC in these 3 risk groups.

Results 746 patients from 47 centers in 22 countries were registered until December 2023. Initially 135 patients were excluded (mostly due to lack of information or inconsistencies). 156 additional patients were excluded due to missing information in the five variables we found associated with OS in the multivariate analysis (p<0.05): FIGO stage, tumor size, post-surgical histology, mitoses per 10 HPF and LSVI. OS differences of the 3 groups is shown in Table 1 Figure A. Median OS in high-risk group in patients with or without AC was 29.93 and 19.15 months respectively (HR 0.48 (0.26-0.88),p=0.02) (Table 1, Figure B). There were no differences in medium and low risk groups (Table 1, Figure C and D).

Conclusion To our knowledge, this is the first study showing a clear benefit in overall survival for a high-risk group of HGUS patients receiving AC, and suggests the potential development of a risk score to identify patients benefiting from AC.

Disclosures Attached.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.