Objective To determine the clinical characteristics and treatment outcomes of women with recurrent uterine leiomyosarcoma (uLMS). Methods We conducted a retrospective cohort study to evaluate the clinical characteristics and survival of women with recurrent uLMS and identify prognostic factors. Results Overall, 71 patients with first recurrence of uLMS were included in our study. 19 patients (26.8%) received systematic therapy and 52 patients (73.2%) received secondary cytoreductive surgery (SCS). In SCS subgroup (n=52), a complete resection with no residual disease was reported in 47 patients (90.4%). 38.5% (20/52) patients received non-genital organ surgeries. 10 (19.2%) patients had received thoracic surgery because of lung-only recurrences. Bowel, bladder surgery was performed in 8 (15.4%), 3 (5.8%) patients, respectively. 1 (1.9%) patient had received liver surgery. The median follow-up duration was 38.7 months (range: 2.7-317.6 months). 41 (57.7%) patients died during follow-up. 5-year OS for the entire cohort was 52.9%. Patients experienced first recurrence after initial diagnoses within 12 months (n=24) had a worse 5-year OS than those after 12 months (n=47) (17.0% vs 69.1%, P<0.001). 5-year OS for the SCS and non-SCS subgroup was 62.0% and 28.0%, respectively (P<0.001). Multivariate analysis showed time to fist recurrence within 12 months (HR=4.60, 95% CI: 1.49-14.4, P = 0.008) was an independent predictor of decreased 5-year OS in SCS subgroup. Conclusion SCS is an important treatment choice for recurrent uLMS and seems to have benefited patients. Time to fist recurrence within 12 months is an independent predictor of decreased 5-year OS in SCS subgroup.

Objective: The therapeutic effect of PARP inhibitors (PARPi) monotherapy compared with platinum-based chemotherapy, and the impact to subsequent platinum-based chemotherapy after PARPi resistance were inconclusive. Design: Retrospective cohort study. Setting: Patients from seven medical centers in China. Population: BRCA1/2-mutated ovarian cancer patients with secondary platinum-sensitive relapse, without any maintenance regimen after first- and second-line platinum therapy, and the secondary platinum-free interval (PFI) was more than 6 months. Methods: Patients in study group (n=31) were treated with PARPi monotherapy until disease progression, and patients in control group (n=33) were treated with platinum-based chemotherapy without restriction. Main Outcome Measures: RECIST and GCIG standard, Kaplan-Meier plotter Results: The objective response rate (ORR: 77.4% vs. 84.0%, p=0.538) and median progression-free survival (mPFS: 8.6 vs. 11.1 months, p=0.679) were comparable. PARPi monotherapy significantly prolonged post-recurrent survival (PRS, HR=0.35, p=0.024), and was the independent factor associated with PRS (HR=0.33, p=0.038). The median time from treatment to first subsequent therapy or death (TFST) of patients with platinum-based chemotherapy after PARPi progression and patients in control group with PFI≥6months after third-line platinum-based chemotherapy was comparable (mTFST: 7.5 vs. 7.1 months, p=0.800). Further survival analysis showed that PRS of patients with PARPi monotherapy were similar to patients with PFI≥6 months after third-line platinum chemotherapy (HR=0.66, p=0.503), and superior to patients with PFI<6 months after third-line platinum chemotherapy (HR=0.15, p=0.009). Conclusions: PARPi monotherapy was equivalent to platinum-based chemotherapy for BRCA1/2-mutated ovarian cancer patients with secondary platinum-sensitive recurrence, and could improve prognosis.