Format

Send to

Choose Destination
Gynecol Oncol. 2016 Jun;141(3):447-453. doi: 10.1016/j.ygyno.2016.04.004. Epub 2016 Apr 14.

Optimal cytoreductive surgery in patients with advanced uterine carcinosarcoma: A multi-institutional retrospective study from the Japanese gynecologic oncology group.

Author information

1
Department of Medical Oncology, Nippon Medical School Musashikosugi Hospital, Kawasaki, Japan. Electronic address: haranokenichi@gmail.com.
2
Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan.
3
Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.
4
Department of Obstetrics and Gynecology, Kagoshima City Hospital, Kagoshima, Japan.
5
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
6
Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Hidaka, Japan.
7
Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan.
8
Department of Obstetrics and Gynecology, Kansai Rosai Hospital, Amagasaki, Japan.
9
Department of Disaster Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan.
10
Department of Gynecology, Aichi Cancer Center, Nagoya, Japan.
11
Department of Gynecologic Oncology, Shikoku Cancer Center, Matsuyama, Japan.
12
Department of Clinical Research Network, Clinical Research Innovation and Education Center, Tohoku University Hospital, Sendai, Japan.
13
Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
14
Department of Gynecology, National Kyushu Cancer Center, Fukuoka, Japan.

Abstract

BACKGROUND:

The benefits of cytoreductive surgery for uterine carcinosarcoma (UCS) are unknown. The objective of this study was to determine the impact of optimal surgery on advanced UCS patient survival.

METHODS:

We performed a multi-institutional, retrospective study of women diagnosed with stage IIIIV UCS between 2007 and 2012. Data were obtained retrospectively from medical records, including demographic, clinicopathologic, treatment, and outcome information. Optimal cytoreductive surgery was defined as surgery resulting in a maximum residual tumor of ≤1cm. The Kaplan-Meier method was used to calculate progression-free survival (PFS) and overall survival (OS), and the Cox regression model was used to examine the impact of selected factors on survival.

RESULTS:

A total of 225 UCS patients (median age, 63years) were identified, including 136 (60%) with stage III and 89 (40%) with stage IV disease. Among these patients, 170 (76%) received optimal cytoreductive surgery. The median follow-up time was 19months. The median PFS was 11.5months (95% confidence interval [CI], 10.6-13.4) and 8.1months (95% CI, 5.1-9.5) for patients who received optimal and suboptimal cytoreductive surgery, respectively (P<0.0001). The median OS was 37.9months (95% CI, 28.3-not reached) and 18months (95% CI, 9.6-21) for patients who received optimal and suboptimal cytoreductive surgery, respectively (P<0.0001). Residual tumor >1cm was associated with worse OS while pelvic lymph node dissection was associated with improved OS.

CONCLUSION:

Optimal cytoreductive surgery and pelvic lymph node dissection are associated with improved OS in advanced UCS patients.

KEYWORDS:

Cytoreductive surgery; Pelvic lymph node dissection; Uterine carcinosarcoma

PMID:
27072806
DOI:
10.1016/j.ygyno.2016.04.004
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center