The TOURISM study (Treatment Outcomes in UteRIne SarcoMa): A 10-year retrospective evaluation of practice in the United Kingdom

Background: Although rare, uterine sarcomas account for a high proportion of uterine<br/>cancer mortality. Treatment options and robust trial data are limited.<br/><br/>Objectives: The TOURISM study (Treatment Outcomes in UteRIne SarcoMa) is a UK-wide<br/>study by the National Oncology Trainees Collaborative for Healthcare Research (NOTCH)<br/>which aimed to characterise this patient cohort.<br/><br/>Design: A retrospective descriptive cohort study. Patients with carcinosarcomas/mixed<br/>Mullerian tumours, non-uterine gynaecological sarcomas and uterine metastases were<br/>excluded. Routine clinical data, including general patient demographics, diagnosis, treatment<br/>and outcomes were collated and pseudonymised.<br/><br/>Setting: Patients diagnosed with uterine sarcoma in the UK National Health Service<br/>between 1st January 2008 and 31st December 2017 were identified from electronic records.<br/>Participants: 406 patients from 8 centres were eligible for inclusion.<br/><br/>Results: The median age at diagnosis was 56 years, with leiomyosarcoma the most<br/>common diagnosis (54.4%). The majority (57.9%) were diagnosed at FIGO stage I, with<br/>19.7% diagnosed at stage IV. Nearly half (45.2%) of patients received at least one line of<br/>chemotherapy, of which most (81.0%) received Doxorubicin first-line. In the stage I group<br/>7.4% received adjuvant chemotherapy and 15.0% received adjuvant radiotherapy. Median<br/>overall survival was 37 months, however survival varied significantly by stage at diagnosis<br/>(stage I: 105 months, stage II: 33 months III: 19 months, stage IV: 14 months).<br/><br/>Conclusions: Our data highlight the diversity in patient management in uterine sarcoma and<br/>a marked survival advantage to patients diagnosed with stage I disease. These data<br/>highlight the importance of a multidisciplinary approach, and describes real-world trends in<br/>systemic therapies, radiotherapy and surgical treatment in this rare cancer type.<br/>