Journal article
The impact of multi-modal therapy on survival for uterine carcinosarcomas
Gynecologic Oncology, Vol.116(3), pp.419-423
2010
DOI: 10.1016/j.ygyno.2009.10.053
PMID: 19896181
Abstract
To investigate treatment outcomes of patients with carcinosarcoma of the uterus and to identify parameters predictive of survival. Secondary objectives included (a) the assessment of treatment failures as a function of histologic subtypes and (b) the impact of the new FIGO staging classification system. This is a retrospective outcomes analysis of 121 patients diagnosed with primary carcinosarcoma of the uterus. Clinical, surgical and pathological data were reviewed and patients were classified according to the new 2009 FIGO staging system for endometrial carcinoma. Survivorship curves were evaluated with the log-rank test and associations between events and variables with Cox proportional hazards model. In the multivariate analyses for disease-specific survival (DSS) and disease-free survival (DFS), the only independent factors were FIGO stage, adjuvant chemotherapy after surgery and the presence of clear cell histology in the tumor. The 5-year DSS for stages I–II, III and IV was 59%, 22% and 9%, respectively. The administration of platin-based chemotherapy provided a significant benefit with regard to both DFS (OR = 0.28; p = 0.001) and DSS (OR = 0.35; p = 0.01). While radiotherapy (RT) appeared to control vaginal failures in all stages, pelvic RT did not impact DSS. Of importance, the epithelial component was the predominant histology in both the primary extrauterine metastases (94%) and the distant failure sites (82%). This highly aggressive uterine malignancy warrants comprehensive surgical staging to assess tumor dissemination followed by systemic therapy in patients with both early and advanced stage disease.
Details
- Title: Subtitle
- The impact of multi-modal therapy on survival for uterine carcinosarcomas
- Creators
- Jesus Gonzalez Bosquet - Laboratory of Translational Genomics, Division of Cancer Epidemiology and Genetics, NCI, NIH, Bethesda, MD 20892, USAShelby A Terstriep - Medical Oncology, Mayo Clinic, Rochester, MN 55905, USAWilliam A Cliby - Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN 55905, USAMonica Brown-Jones - Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN 55905, USAJudith S Kaur - Medical Oncology, Mayo Clinic, Rochester, MN 55905, USAKarl C Podratz - Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN 55905, USAGary L Keeney - Department of Anatomic Pathology, Mayo Clinic, Rochester, MN 55905, USA
- Resource Type
- Journal article
- Publication Details
- Gynecologic Oncology, Vol.116(3), pp.419-423
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.ygyno.2009.10.053
- PMID
- 19896181
- ISSN
- 0090-8258
- eISSN
- 1095-6859
- Language
- English
- Date published
- 2010
- Academic Unit
- Obstetrics and Gynecology
- Record Identifier
- 9983931741702771
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