Gemcitabine Hydrochloride and Docetaxel Followed by Doxorubicin Hydrochloride or Observation in Treating Patients With High-Risk Uterine Leiomyosarcoma Previously Removed by Surgery

All patients must have no evidence of persistent or metastatic disease as documented by a post-resection computed tomography (CT) of the chest/abdomen/pelvis or by CT chest + magnetic resonance imaging (MRI) abdomen/pelvis; the post-resection imaging studies should be performed within 4 weeks of registration on study

Absolute neutrophil count (ANC) greater than or equal to 1,500/mcL (ANC \>= 1.5 x 10\^9/liter \[L\])

Platelets greater than or equal to 100,000/mcL (platelets \>= 100 x 10\^9/L)

Hemoglobin greater than 8.0 g/dL (= 80 g/L or 4.9 mmol/L)

Creatinine less than or equal to 1.5 x institutional upper limit of normal (ULN)

Bilirubin\* within normal range

Serum glutamic oxaloacetic transaminase (SGOT) (aspartate aminotransferase \[AST\])\* and serum glutamate pyruvate transaminase (SGPT) (alanine aminotransferase \[ALT\])\* less than or equal to 2.5 times ULN

Alkaline phosphatase\* less than or equal to 2.5 x ULN

\* Patients with a history of Gilbert?s syndrome may be eligible provided total bilirubin is less than or equal to 1.5 x ULN and the AST, ALT, and alkaline phosphatase meet the criteria detailed

Neuropathy (sensory and motor) less than or equal to Common Terminology Criteria for Adverse Events (CTCAE) grade 1

Patients with Gynecologic Oncology Group (GOG) performance status of 0 or 1 OR Eastern Cooperative Oncology Group (ECOG) PS of 0 or 1 OR Karnofsky performance status (PS) \>= 80%

Patients who have met the pre-entry requirements specified

Patients must have signed an approved informed consent

Patients participating through United States (U.S.) sites must sign an approved and authorization permitting release of personal health information

Patients should be free of active infection requiring antibiotics (with the exception of an uncomplicated urinary tract infection \[UTI\])

Patients with a history of severe hypersensitivity reaction to Taxotere (docetaxel) or other drugs formulated with polysorbate 80

Patients with GOG performance status of 2, 3 or 4; or ECOG performance status of 2, 3 or 4

Patients who are breast-feeding

Patients with a known history of congestive heart failure or cardiac ejection fraction \< 50% (or less than institutional normal limits); echocardiogram (ECHO) or multigated acquisition scan (MUGA) is not required prior to enrollment; for patients assigned to the chemotherapy arm, an ECHO or MUGA should be done within 6 months of day 1 of gemcitabine-docetaxel treatment

* Patients who enroll on study and are randomized to Regimen I (chemotherapy ) and then are found on baseline ECHO or MUGA to have cardiac ejection fraction \< 50% or below institutional normal will remain ON study; such patients will receive gemcitabine + docetaxel for 4 cycles but will NOT receive any doxorubicin treatment; they will continue treatment follow-up as outlined for all patients assigned to Regimen I

Patients with a history of prior whole pelvic radiation

Concurrent treatment with hormone replacement therapy is permitted at the discretion of the treating physician; patients who have been taking hormonal/hormone blocking agents for breast cancer or breast cancer prevention or other indication are eligible; use of anti-hormonal agents (tamoxifen, medroxyprogesterone, aromatase inhibitors) is permitted at the discretion of the treating physician; documentation of concurrent medications is required

Patients with recurrent uterine LMS

What this study is about