Vaz J, Tian C, Richardson MT, et al. - Using the National Cancer Database, researchers investigated the influence of adjuvant chemotherapy (ACT) as well as prognostic factors in surgically treated patients with stage I uterine leiomyosarcoma (ULMS). Participants were women on whom hysterectomy was performed and who received a diagnosis of stage I ULMS between 2010 and 2014. Overall participants were 1,059, including 514 managed with ACT and 545 with no ACT. The identified independent prognostic factors were: patient age, comorbidity score, tumor size, lymphovascular space invasion and grade, as revealed in the multivariate survival analysis. For ACT vs no ACT, the adjusted five-year survival was estimated to be 61.7% vs 61.3% and restricted mean survival time was estimated to be 39.7 vs 40.6 months, respectively, following propensity score weighting to control for the imbalance of prognostic clinical factors. No improvement in survival was achieved with ACT vs no ACT in patients with stage I ULMS. ACT was found to be inferior in patients having low-grade tumors.