Toyoshima M, Akahira J, Matsunaga G, Niikura H, Ito K, Yaegashi N, Tase TClinical experience with combination paclitaxel and carboplatin therapy for advanced or recurrent carcinosarcoma of the uterus. Gynecol Oncol 94: 774-778
Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan. Gynecologic Oncology
(Impact Factor: 3.77).
10/2004; 94(3):774-8. DOI: 10.1016/j.ygyno.2004.05.048
The purpose of the study was to evaluate the efficacy of combination chemotherapy with paclitaxel and carboplatin in patients with advanced or recurrent carcinosarcoma of the uterus.
A retrospective review was carried out at Miyagi Prefecture Cancer Research Center Hospital. Six patients pathologically diagnosed with uterine carcinosarcoma were treated with paclitaxel (175 mg/m(2) given intravenously over 3 h) and carboplatin (dosed at AUC 6) every 3 weeks at our center between 1997 and 2003. Responses and adverse effects were assessed according to Response Evaluation Criteria in Solid Tumors and National Cancer Institute-Common Toxic Criteria, respectively.
All six patients were evaluable for toxicity, and no unacceptably severe toxicities were reported. Grades 3 and 4 hematologic toxicities occurred, but all of them were overcome by adequate treatment with granulocyte colony-stimulating factor and blood transfusions. Five of six patients had measurable disease and thus were evaluable for response: Four patients had a complete response (CR) and the remaining patient had progressive disease (PD). The median progression-free interval (PFI) for all six cases was 18 months, with a median overall survival of 25 months.
Although the number of cases was small, the regimen evaluated in the current study demonstrated higher activity and lesser toxicity than those found in previous studies in patients with advanced or recurrent uterine carcinosarcoma. Additional phase II clinical studies are necessary to evaluate fully the benefits of this regimen.
Available from: Naoto Furukawa
- "The Gynecologic Oncology Group has tested paclitaxel in a variety of studies and has reported activity in ovarian cancer and adenocarcinoma of the endometrium, as well as in squamous and nonsquamous cancers of the cervix. The combination of paclitaxel and carboplatin demonstrated higher activity than that found in previous studies in patients with advanced or recurrent uterine carcinosarcoma . In our first case, adjuvant chemotherapy comprising paclitaxel and carboplatin was administered after surgery, and 2 years after the end of treatment, the patient is still disease-free. "
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ABSTRACT: We report two cases of uterine carcinosarcoma associated with alpha-fetoprotein (AFP)-producing hepatoid adenocarcinoma. Samples were obtained from two women aged 63 and 82 years. Serum AFP levels of the two samples were 10,131 and 401 ng/ml, respectively. Histologically, in both cases the tumor cells were composed of hepatoid adenocarcinoma component and sarcoma component including rhabdomyosarcoma. Immunohistochemical analyses revealed that AFP was expressed in the cytoplasm of the carcinomatous component. After surgery, the patients received six courses of carboplatin/paclitaxel chemotherapy, and the serum levels of AFP decreased to normal range. The first patient is alive and well at the 2-year follow-up, while the second patient died of disease 1 year after initial operative treatment. This is, to our knowledge, the second report of carcinosarcoma of the uterine corpus with AFP-producing hepatoid adenocarcinoma, as proven by immunohistochemical analyses.
Available from: Wenbin Wei
- "Additionally we included sarcomas, carcinosarcomas and uterine tumours of mixed histology for the same reason – they are also poor prognosis tumours with currently no adjuvant treatment that has shown to clearly improve survival (Sutton et al, 2000; Deniaud- Alexandre et al, 2001; Weitmann et al, 2002; Giuntoli et al, 2003; Livi et al, 2003; Toyoshima et al, 2004). Although the tissue set contains divergent histology types, clinically these tumours result in poor outcome and justify being investigated together. "
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ABSTRACT: Type II cancers account for 10% of endometrial cancers but 50% of recurrence. Response rates to chemotherapy at recurrence are poor and better prognostic markers are needed to guide therapy. CD151 is a small transmembrane protein that regulates cell migration and facilitates cancer metastasis. High CD151 expression confers poor prognosis in breast, pancreatic and colorectal cancer. The prognostic significance of tetraspanin CD151 expression in poor outcome endometrial cancers was evaluated, along with oestrogen receptor (ER), progesterone receptor (PR), p53, human epidermal growth factor receptor -2 (HER-2), and CD 151 staining compared with α6β1, α3β1 integrins, and E-cadherin.
Tissue microarray constructed from 156 poor outcome endometrial cancers, tested with immunohistochemistry and staining correlated with clinicopathological data were used. A total of 131 data sets were complete for analysis.
Expression of CD151 was significantly higher in uterine papillary serous and clear cell carcinoma than in grade 3 endometrioid carcinoma, sarcoma or carcinosarcoma (P<0.001). In univariate analysis, age, stage, histology type and CD151 were significant for both recurrence free (RFS) and disease specific survival (DSS). In multivariate analyses, CD151 was significant for RFS and DSS (P=0.036 and 0.033, respectively) in triple negative (ER, PR and HER-2 negative) tumours (88/131). The HER-2, p53, ER and PR were not prognostic for survival. There was strong concordance of CD151 with E-cadherin (98%), but not with α6β1 (35%), α3β1 staining (60%).
The CD151 is a novel marker in type 2 cancers that can guide therapeutic decisions. CD151 may have an important role in tumourigenesis in some histology types.
Available from: Eddie Murta
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ABSTRACT: To verify the relationship between clinical variables and tumor stage in breast cancer.
This retrospective study (1998 to 2001) analyzed data of 176 women with breast cancer attending a university hospital. Patients were divided into groups according to the clinicopathological variables studied.
The disease had a similar frequency at age under 50 years (44.3%) or above (55.7%) 50 years. Stage II was more frequent. Most patients were white (69.9%), non-smokers (69.3%) and were not using oral contraceptives (71%). Stages 0-II were mainly detected in the white (74.8%) vs non-white (60.4%) group. Monthly breast self-exams were performed by 62.5% of women, in which earlier stages (0, I) were more frequently detected than in those who did not perform self-exams (27.3% vs 12.1%, p = 0.01).
Breast cancer occurred mainly in white women in Stage II, and with similar frequency at age under or over 50 years. Breast self-exam was associated with early detection of the disease.
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