Factors affecting the outcome of patients with metastatic leiomyosarcoma treated with doxorubicin-containing chemotherapy.

BACKGROUND To determine whether pulmonary metastasectomy or the addition of ifosfamide/dacarbazine to a doxorubicin-containing regimen offers a survival benefit to adult patients with metastatic leiomyosarcoma. PATIENTS AND METHODS We retrospectively collected data from 147 patients treated with a doxorubicin-containing regimen from 1998 to 2008. RESULTS Progression-free survival (PFS) was 6.5 months (range 1-141 months). We did not identify an independent prognostic factor for PFS. Planned dose of doxorubicin was the sole parameter improving PFS [hazard ratio (HR) = 0.13, P = 0.023]. Overall survival (OS) was 17 months (range 1-115 months). The sole identified prognostic factor for OS was the interval between initial diagnosis and metastatic relapse. After adjustment to this prognostic factor, metastasectomy improved OS (HR = 0.52, P = 0.012) and the addition of ifosfamide seemed to worsen OS (HR = 1.42, P = 0.028). CONCLUSION In our analysis, combined regimens did not improve the outcome. Maintenance of the doxorubicin dose was associated with improved PFS. Metastasectomy favorably influenced OS.