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The relationship between histology and outcome in advanced and recurrent endometrial cancer patients participating in first-line chemotherapy trials : a Gynecologic Oncology Group study . OBJECTIVES To explore associations between histology and outcome in advanced or recurrent endometrial cancer patients participating in Gynecologic Oncology Group chemotherapy trials . METHODS Age , race , performance status , histologic type ( serous=S ; clear cell=CC ; endometrioid=E ) , disease stage , and prior radiation were evaluated using various analytic methods to evaluate the probability of response and identify independent predictors of progression-free survival ( PFS ) and overall survival ( OS ) . RESULTS Single agent or combination chemotherapy regimens including doxorubicin ( A ) ( 12 % ) , doxorubicin/cisplatin ( AP ) ( 63 % ) , doxorubicin/paclitaxel ( AT ) ( 13 % ) , and paclitaxel/doxorubicin/cisplatin ( TAP ) ( 11 % ) were used among 1203 patients treated on 4 randomized clinical trials . Breakdown of disease stage was 7.8 % stage III , 22.8 % stage IV , and 69.4 % recurrent disease . Histologic distribution was 18 % S , 3.7 % CC , 8.5 % mixed , 51.7 % E and 18.1 % other . More S/CC patients enrolled on trials with advanced stage ( III-IV ) disease ( as opposed to recurrent disease ) compared to E patients ( 45 % vs. 24 % , p < 0.05 ) . Overall response rate was 42 % ( E=44 % , S=44 % , CC=32 % ) . Histologic type was not an independent predictor of response . Independent predictors of PFS included race , performance status , disease stage , and CC histology . Histology was also an independent predictor of OS ; the relative hazard ratio for S histology was 1.2 ( 1.02-1.4 ; p=0.03 ) , and for CC was 1.51 ( 1.1-2.07 ; p=0.01 ) . CONCLUSION In patients with advanced/recurrent endometrial cancer treated with A , P and/or T , response was not associated with histology . This exploratory analysis does not support exclusion of S tumors in future trials . Poorer PFS and OS were observed in CC compared to other types , but a lack of benefit from chemotherapy was not shown , and as this histology represents such a small fraction , it does not seem feasible to have separate chemotherapy trials for CC .
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Intervention_Pharmacological
chemotherapy
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Intervention_Physical
various analytic methods to evaluate the probability of response and identify independent predictors of progression-free survival ( PFS ) and overall survival ( OS )
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Intervention_Pharmacological
Single agent
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Intervention_Pharmacological
combination chemotherapy regimens
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Intervention_Pharmacological
doxorubicin ( A )
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Intervention_Pharmacological
doxorubicin/cisplatin
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Intervention_Pharmacological
doxorubicin/paclitaxel
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Intervention_Pharmacological
paclitaxel/doxorubicin/cisplatin
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Outcome_Other
histology
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Outcome_Physical
outcome
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Outcome_Physical
performance status
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Outcome_Physical
histologic type
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Outcome_Physical
disease stage
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Outcome_Physical
prior radiation
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Outcome_Mortality
progression-free survival ( PFS )
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Outcome_Mortality
overall survival ( OS )
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Outcome_Physical
disease stage
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Outcome_Physical
Histologic distribution
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Outcome_Physical
response rate
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Outcome_Physical
Histologic type
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Outcome_Physical
performance status
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Outcome_Physical
disease stage
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Outcome_Physical
CC histology
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Outcome_Physical
Histology
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Outcome_Mortality
relative hazard ratio
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Outcome_Physical
histology
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Outcome_Mortality
PFS
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Outcome_Mortality
OS
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Participant_Condition
advanced and recurrent endometrial cancer patients participating in first-line chemotherapy trials
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Participant_Condition
advanced or recurrent endometrial cancer patients participating in Gynecologic Oncology Group chemotherapy trials
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Participant_Sample-size
1203
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Participant_Sample-size
4
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Participant_Condition
patients with advanced/recurrent endometrial cancer