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eight patients who had infertility at diagnosis were able to conceive and deliver
normally after treatment.
Conclusion: Borderline ovarian tumours have an excellent prognosis. Fertility
sparing surgery is a feasible option in these patients and is compatible with a
favourable long term outcome.
Disclosure: All authors have declared no conflicts of interest.
1012 THE PROGNOSTIC FACTOR ANALYSIS OF MALIGNANT
MIXED MüLLERIAN TUMOR; BASED ON
CLINICOPATHOLOGIC FACTORS
B. Kang 1 , S. Noh 2 , S. Lee 3
1 Internal Medicine, Yonsei Univ. Severance Hospital, Seoul, KOREA, 2 Pathology,
Yonsei Univ. Severance Hospital, Seoul, KOREA, 3 Department of Internal
Medicine, Yonsei University College of Medicine, Seoul, KOREA
Background: Malignant mixed müllerian tumor (MMMT) is a rare and highly
aggressive malignancy with biphasic pathologic characteristics; epithelial and
mesenchymal components. Until now, its prognosis is still poor and there is no
individualized therapy according to the biological characteristics. The aim of this
study was to analyze the clincopathological features and identify the prognostic
factors which impact the survival outcome.
Methods: A retrospective review of patients with MMMT who treated between 1994
and 2011 in our institution was undertaken. The clinical variables such ad age, BMI,
CA-125 at diagnosis, stage, extent of surgery, pathologic findings, adjuvant
chemotherapy and radiation therapy were analyzed. Univariate and multivariate
analysis were done.
Results: The study included 62 patients. The median age was 58 years
(range37.8-79.6). FIGO stages I, II, III, and IV were identified in 38.7%, 4.8%, 32.3%,
and 24.2% respectively. Epithelial dominant, similar, and mesenchymal dominant
pathologic type were 56.3%, 16.7%, and 27.1%. Fifty nine of 62 patients had
undergone hysterectomy and salpingo-oophrectomy and 43 of 62 patients had
lymphadenectomy. Chemotherapy was given to 50 patients (ifosfamide + cisplatin 17,
taxol/taxotere + cisplatin 17, ifosfamide mono 4, other regimens 14). The pattern of
recurrence was mainly local. Median progression-free- survival after diagnosis is only
13.3months and median overall survival is 18.3months. Adjuvant chemotheray and
radiation therapy had no significant survival benefit. Univariate analysis showed
CA-125 at diagnosis (HR 2.39; p = 0.02), FIGO stage I, II vs III, IV (HR 4.07; p = 0.00),
myometrial invasion depth (HR 0.87; p = 0.05), lymphovascular invasion(HR 2.35; p
= 0.03), and lymphadenectomy (HR 0.37; p = 0.01) had an independent influence on
progression free survival. In multivariate analysis, FIGO stage I, II vs III, IV (p = 0.05)
and lymphadenectomy (p = 0.05) were significant. However, pathologic type and
chemotherapy regimen were not associated with risk of recurrence or death.
Conclusions: According to this study, the comprehensive surgical staging is more
important to predict the prognosis than its pathologic characteristics. Further molecular
studies are needed to find out for breakthrough the poor prognosis of MMMT.
Disclosure: All authors have declared no conflicts of interest.
1013 PREDICTING FACTORS OF SECONDARY RESECTION AFTER
NEOADJUVANT CHEMOTHERAPY IN LOCALLY ADVANCED
EPITHELIAL OVARIAN CANCERS. A RETROSPECTIVE STUDY
OF 82 CASES
L. Ben Fatma 1 , S. Said 1 , M. Boudagga 1 , M. Hochlef 1 , F. Zairi 1 , H. Khairi 2 ,
O. Gharbi 1 , H. Boussen 3 , S Ben Ahmed 1
1 Medical Oncology, Hopital Farhat Hached, Sousse, 2 Gynecologic Dept, Hopital
Farhat Hached Sousse and, 3 Medical Oncology, Hopital A Mami, Tunis, TUNISIA
Objective: The aims of our study were to assess the rate of optimal interval
debulking surgery (IDS) and the potential predictors of chemotherapy responsiveness
in patients treated with neoadjuvant chemotherapy(NACT).
Methods: We present a retrospective study including 82 EOC cases (stage IIIC or IV)
collected in the medical oncology department of Farhat Hached Hospital-Sousse
(Tunisia) during a period of 9 years (from 2002 to 2010). All patients received
NACT followed by a clinical, radiological and biological assessment.
Results: The mean age of our patients was 54.5 years (27-80 years). Stage IIIC
represented 69.5% of all cases and stage IV 30.5% (8 cases with pleural metastases,
14 cases with liver metastases, and 3 with pleural and liver metastases). CA-125
serum level was normal in only 7 cases. All patients received a mean number of 5
cycles of platinum-based NACT associated with paclitaxel in 78% of cases. Twenty
seven patients achieved complete clinical response (CCR), 28 a partial clinical
response (PCR) and 17 cases have disease progression. In 46/82 pts(56%), serum
CA-125 was normalized after NACT. Ten patients achieved a radiological CR.
Radiological PR was noted in 44 cases, while 19 patients had radiological disease
progression. The rate of secondary resection was 51% (61.4% for stage IIIC and 28%
for stage IV). Thirty one patients (74%) had an optimal IDS. We observed 9
pathological complete responses (pCR). Secondary optimal resection was
significantly correlated to CA-125 serum level at the end of NACT (p = 0.001) and
Annals of Oncology
the quality of radiological response (CR or PR) (p = 0.001). Overall survival was 28.4
months, significantly better in cases of clinical or radiological complete response
(p = 0.001) and in patients with optimal IDS (p = 0.01). pCR was associated with
higher survival but without significant value (p = 0.08). In multivariate analysis, the
parameters predicting a prolonged survival were: radiological complete or partial
response (p = 0.05), optimal surgery (p = 0.001) and pCR (p = 0.03).
Conclusion: In initially unresectable EOC, NACT platinum-based chemotherapy
followed by IDS is a therapeutic alternative leading to a higher rate of optimal
surgery with an improvement of survival. Pre-operative CA-125 serum level as well
as the radiological response appeared to be good predictors of secondary R0 surgery
and tumor chemosensitivity.
Disclosure: All authors have declared no conflicts of interest.
1014 IMPACT OF CHEMOTHERAPY BEYOND THE THIRD LINE IN
PATIENTS WITH RECURRENT EPITHELIAL OVARIAN CANCER
L. Mansi 1 , E. Kalbacher 1 , M. Demarchi 2 , F. Bazan 3 , M. Schneider 4 , A. Vuillemin 5 ,
S. Bernhard 6 , V. Nerich 7 , C. Borg 8 , X. Pivot 9
1 Doubs, Oncology, Besancon, FRANCE, 2 Valencia, Oncology, Valencia, SPAIN,
3 Besancon, Oncology, Besancon, FRANCE, 4 Nice, Oncology, Nice, FRANCE,
5 Medical Oncology, Hôpital Jean Minjoz, Besançon, FRANCE, 6 Department of
Medical Oncology, University Hospital J. Minjoz, Besancon, FRANCE,
7 Pharmacy, Hopital Minjoz, Besançon, FRANCE, 8 Medical Oncology, University
Hospital Besançon, Besançon, FRANCE, 9 Medical Oncology, Hopital Minjoz,
Besançon, FRANCE
Objectives: The goal of this study was to determine the benefit in terms of time to
disease control (TDC) achieved by the succession of chemotherapy lines beyond the
third line in patients treated for recurrent epithelial ovarian cancer (EOC). Secondary
objective were to identify patients who benefit from treatments beyond line three,
and overall survival beyond the fourth line.
Methods: The cohort of patients was identified from a pharmacy database of
cytotoxic chemotherapy administered between 1992 and 2010 at our regional center.
Among 591 cases of EOC, a total of 122 patients were treated by more than 3 lines
of chemotherapy. The evaluation of benefit obtained by each chemotherapy lines was
based on TDC. Cox proportional hazards model was used to identify factors that
could influence the TDC in each line of chemotherapy. Survival data was computed
according to Kaplan-Meier method.
Results: Median OS was 53 months (95% CI, 47 to 67 months), and median OS
after the third line was 15,3 months (95% CI, 12 to 20 months). Factors associated
with longer OS after third line were performance status lower than 2 (p = 0.0058), no
hepatic (p = 0.0098) and no pulmonary disease progression (p = 0.0003). Median
durations of TDC was 4.15 (0 – 54.7), 4 (0 – 21.7), 3.34 (0 – 29.6), 4.97 (0 – 29.2),
and 3.13 months (0 – 15), in fourth, fifth, sixth, seventh, eighth line, respectively.
TDC was longer than 6 months in 34% to 40% of patients treated by line 4 to
8. The most important factor influencing TDC length in multivariate analysis
beyond the third lines was the TDC duration obtained by the 2 previous lines of
therapy (p = 0.03).
Conclusion: One can consider that those results might justify the administration of
chemotherapy beyond the third line, in particular when the 2 previous lines are
effective and let a disease control for more than six months.
Disclosure: All authors have declared no conflicts of interest.
1015 PROGNOSTIC FACTORS AND TREATMENT OUTCOMES OF
PATIENTS WITH UTERINE LEIOMYOSARCOMA: A
RETROSPECTIVE STUDY OF ANATOLIAN SOCIETY OF
MEDICAL ONCOLOGY
A. Durnali 1 , S. Tokluog˘ lu 2 , N. Ozdemir 3 ,M.I˙nanc 4 , N. Alkis 1 , N. Zengin 3 ,
O.U. Sonmez 1 , M. Kucukoner 5 , M. Ozkan 6 , B. Oksuzoglu 1
1 Department of Medical Oncology, Ankara Dr.A.Y.Oncology Research and
Education Hospital, Ankara, TURKEY, 2 Medical Oncology, Güven Hospital,
Ankara, TURKEY, 3 Medical Oncology, Numune Education and Research
Hospital, Ankara, TURKEY, 4 Department of Medical Oncology, Erciyes University,
Kayseri, TURKEY, 5 Medical Oncology, Dicle University, Diyarbakir, TURKEY,
6 Medical Oncology, Erciyes University Medical FacultyM.Kemal Dedeman,
Oncology Hospital, Kayseri, TURKEY
Background: Uterine leiomyosarcomas are infrequent and aggressive malignancies of
female genital tract.
Methods: Data of 54 uterine leiomyosarcoma patients who were diagnosed and
treated at 4 different centers from November 2000 to October 2010 were analysed
retrospectively.
Results: Mean age was 50.8 years (range 34-72), and 54.9% of patients were
premenapousal. According to last International Federation of Gynecology and
Obstetrics (FIGO) staging system, 26 (48.1%) patients had stage I disease, 14 (25.9%)
stage II, 5 (9.3%) stage III, and 9 (16.7%) stage IV. Of the 52 patients who
underwent surgery, 38.4% (20 patients) were given adjuvant chemotherapy, 17.3% (9
ix332 | Abstracts Volume 23 | Supplement 9 | September 2012