@article {Odunsi659, author = {K. Odunsi and V. Moneke and J. Tammela and S. Ghamande and P. Seago and D. Driscoll and D. Marchetti and T. Baker and S. Lele}, title = {Efficacy of adjuvant CYVADIC chemotherapy in early-stage uterine sarcomas: results of long-term follow-up}, volume = {14}, number = {4}, pages = {659--664}, year = {2004}, doi = {10.1136/ijgc-00009577-200407000-00014}, publisher = {BMJ Specialist Journals}, abstract = {Data on adjuvant chemotherapy in early-stage uterine sarcomas are conflicting and most often based on small patient groups with relatively short duration of follow-up. Approximately 60\% of patients present with stage I disease with an overall 5-year survival of 30{\textendash}50\% when treated with surgery alone. This study examines the efficacy and results of long-term follow-up of a multiagent chemotherapy regimen of cyclophosphamide, vincristine, doxorubicin, and dacarbazine (CYVADIC) as adjuvant treatment for patients with stage I uterine sarcoma. Between 1982 and 1999, 24 evaluable patients with completely staged uterine sarcomas received adjuvant multiagent chemotherapy with vincristine sulfate (1mg/m2) on days 1 and 4, doxorubicin (40 mg/m2) and cyclophosphamide (400 mg/m2) on day 2, and dacarbazine (200 mg/m2) on days 1 through 4 for a total of nine monthly cycles or until recurrence of disease was documented. Survival distributions were calculated by the Kaplan{\textendash}Meier method, and statistical significance was determined with the log-rank test. Factors significant on univariate analysis were analyzed in a multivariate fashion using Cox proportional hazards model. The histologic distribution of patients was 46\% leiomyosarcoma, 33\% mixed mullerian tumors, 13\% stromal sarcomas, 4\% adenosarcomas, and 4\% hemangiosarcoma. The patients received 206 of a planned 216 cycles of chemotherapy. The median follow-up of the patient population was 93 months (range 11{\textendash}213 months). Eight patients (33\%) developed recurrent disease. The median time to recurrence was 19 months (range 7{\textendash}184 months). The estimated survival for the entire group was 88, 75, and 69\% at 2, 5, and 15 years, respectively. Factors that did not affect survival included age, histology, and tumor grade. Four patients required dose reductions secondary to grade 2{\textendash}3 toxicities (hematologic). Grade 1 neurotoxicity was observed in six patients (25\%) and grade 2 neurotoxicity in one patient (4\%). Adjuvant CYVADIC chemotherapy appears to be safe and well tolerated in patients with stage I uterine sarcomas. Our data provide information on the longest duration of follow-up ever reported and suggests that CYVADIC may have a potential role in the adjuvant treatment of early-stage uterine sarcoma.}, issn = {1048-891X}, URL = {https://ijgc.bmj.com/content/14/4/659}, eprint = {https://ijgc.bmj.com/content/14/4/659.full.pdf}, journal = {International Journal of Gynecologic Cancer} }