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Int J Clin Oncol. 2016 Feb;21(1):168-76. doi: 10.1007/s10147-015-0859-7. Epub 2015 Jun 18.

Prognostic factors in patients with 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, 1-396 Kosugi-cho, Nakahara-ku, Kawasaki, Kanagawa, 211-0063, Japan. 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:

Uterine carcinosarcomas (UCSs) are rare and aggressive tumors. The prognostic factors are not sufficiently known.

METHODS:

We performed a multi-institutional, retrospective study of women with stage I-IV UCS, diagnosed between 2007 and 2012. Data obtained from medical records included demographic, clinicopathological, treatment, and outcome information.

RESULTS:

A total of 486 patients (median age 65 years) were identified-224 (46 %) were stage I, 32 (7 %) were stage II, 139 (28 %) were stage III, and 91 (19 %) were stage IV. Among them, 277 (57 %) had disease recurrence. Median disease-free survival (DFS) was 16.4 months [95 % confidence interval (CI) 15.7-27.2], and median overall survival (OS) was 72.0 months (95 % CI 43.0-not reached). In total, 454 (94 %) patients received adjuvant treatment, and 440 (91 %) received adjuvant chemotherapy. In multivariate analysis, stage III-IV disease, CA-125 level, and lymphovascular space invasion (LVSI) were significantly associated with shorter median DFS. Stage III-IV disease, performance status 2-4, ≥50 % myometrial invasion depth, and postsurgical residual tumor size >1 cm were significantly associated with shorter median OS. Conversely, pelvic lymph node lymphadenectomy was associated with improved DFS and OS.

CONCLUSIONS:

Stage, performance status, CA-125 level, LVSI, and myometrial invasion were associated with poor prognoses. Pelvic lymphadenectomy was associated with improved survival, and may be necessary for the surgical management of UCS.

KEYWORDS:

Lymphadenectomy; Pelvic lymph node; Prognostic factor; Uterine carcinosarcoma

PMID:
26084780
DOI:
10.1007/s10147-015-0859-7
[Indexed for MEDLINE]

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