PMID- 29248197
OWN - NLM
STAT- MEDLINE
DCOM- 20180702
LR  - 20180702
IS  - 1095-6859 (Electronic)
IS  - 0090-8258 (Linking)
VI  - 148
IP  - 2
DP  - 2018 Feb
TI  - Significance of venous thromboembolism in women with uterine carcinosarcoma.
PG  - 267-274
LID - S0090-8258(17)31546-9 [pii]
LID - 10.1016/j.ygyno.2017.11.036 [doi]
AB  - OBJECTIVE: To identify risk factors for venous thromboembolism (VTE) and to
      examine the association of VTE and survival in women with uterine carcinosarcoma.
      METHODS: This multicenter retrospective study examined 906 women who underwent
      primary surgical treatment for stage I-IV uterine carcinosarcoma. Time-dependent 
      analyses were performed for cumulative incidence of VTE after surgery on
      multivariate models. RESULTS: There were 72 (7.9%) women who developed VTE after 
      surgery with 1-, 2-, and 5-year cumulative incidences being 5.1%, 7.3%, and
      10.2%, respectively. On multivariate analysis, older age (hazard ratio [HR] per
      year 1.03, P=0.012), non-Asian race (HR 6.28, P<0.001), large body habitus (HR
      per kg/m(2) 1.04, P=0.014), residual disease at surgery (HR 3.04, P=0.003), tumor
      size >/=5cm (HR 2.73, P=0.003), and stage IV disease (HR 2.12, P=0.025) were
      independently associated with increased risk of developing VTE. A risk pattern
      analysis identified that obese Non-Asian women with large tumors (13.7% of
      population) had the highest incidence of VTE (2-year cumulative rate, 26.1%)
      whereas Asian women with no residual disease (47.1% of population) had the lowest
      (2-year cumulative rate, 1.6%) (P<0.001). Presence of carcinoma/sarcoma in
      metastatic sites was significantly associated with increased risk of VTE compared
      to carcinoma alone (2-year rates, 31.2% versus 8.4%, P=0.049). VTE was
      independently associated with decreased progression-free survival on multivariate
      models (5-year rates, 24.9% versus 47.2%, HR 1.46, 95%CI 1.05-2.04, P=0.026).
      CONCLUSION: Our study suggests that VTE represents a surrogate marker of
      aggressive tumor behavior and diminished patient condition in uterine
      carcinosarcoma; obese Non-Asian women with large tumors carry a disproportionally
      high risk of VTE, suggesting that long-term prophylaxis may benefit this
      population.
CI  - Copyright (c) 2017 Elsevier Inc. All rights reserved.
FAU - Matsuo, Koji
AU  - Matsuo K
AD  - Division of Gynecologic Oncology, Department of Obstetrics and Gynecology,
      University of Southern California, CA, USA. Electronic address:
      koji.matsuo@med.usc.edu.
FAU - Ross, Malcolm S
AU  - Ross MS
AD  - Division of Gynecologic Oncology, Department of Obstetrics and Gynecology,
      Magee-Womens Hospital, University of Pittsburgh, PA, USA.
FAU - Im, Dwight D
AU  - Im DD
AD  - The Gynecologic Oncology Center, Mercy Medical Center, Baltimore, MD, USA.
FAU - Klobocista, Merieme M
AU  - Klobocista MM
AD  - Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Albert
      Einstein College of Medicine, Montefiore Medical Center, NY, USA.
FAU - Bush, Stephen H
AU  - Bush SH
AD  - Division of Gynecologic Oncology, Department of Obstetrics and Gynecology,
      Moffitt Cancer Center, University of South Florida, FL, USA.
FAU - Johnson, Marian S
AU  - Johnson MS
AD  - Division of Gynecologic Oncology, Department of Obstetrics and Gynecology,
      University of Kentucky, KY, USA.
FAU - Takano, Tadao
AU  - Takano T
AD  - Department of Obstetrics and Gynecology, Tohoku University, Miyagi, Japan.
FAU - Blake, Erin A
AU  - Blake EA
AD  - Division of Gynecologic Oncology, Department of Obstetrics and Gynecology,
      University of Colorado, CO, USA.
FAU - Ikeda, Yuji
AU  - Ikeda Y
AD  - Department of Obstetrics and Gynecology, The University of Tokyo, Tokyo, Japan.
FAU - Nishimura, Masato
AU  - Nishimura M
AD  - Department of Obstetrics and Gynecology, Tokushima University, Tokushima, Japan.
FAU - Ueda, Yutaka
AU  - Ueda Y
AD  - Department of Obstetrics and Gynecology, Osaka University, Osaka, Japan.
FAU - Shida, Masako
AU  - Shida M
AD  - Department of Obstetrics and Gynecology, Tokai University, Kanagawa, Japan.
FAU - Hasegawa, Kosei
AU  - Hasegawa K
AD  - Department of Obstetrics and Gynecology, Saitama Medical University International
      Medical Center, Saitama, Japan.
FAU - Baba, Tsukasa
AU  - Baba T
AD  - Department of Obstetrics and Gynecology, Kyoto University, Kyoto, Japan.
FAU - Adachi, Sosuke
AU  - Adachi S
AD  - Department of Obstetrics and Gynecology, Niigata University, Niigata, Japan.
FAU - Yokoyama, Takuhei
AU  - Yokoyama T
AD  - Department of Obstetrics and Gynecology, Osaka Rosai Hospital, Osaka, Japan.
FAU - Satoh, Shinya
AU  - Satoh S
AD  - Department of Obstetrics and Gynecology, Tottori University, Tottori, Japan.
FAU - Machida, Hiroko
AU  - Machida H
AD  - Division of Gynecologic Oncology, Department of Obstetrics and Gynecology,
      University of Southern California, CA, USA.
FAU - Yanai, Shiori
AU  - Yanai S
AD  - Department of Obstetrics and Gynecology, Kurashiki Medical Center, Okayama,
      Japan.
FAU - Iwasaki, Keita
AU  - Iwasaki K
AD  - Department of Obstetrics and Gynecology, Aichi Medical University, Aichi, Japan.
FAU - Miyake, Takahito M
AU  - Miyake TM
AD  - Department of Obstetrics and Gynecology, Kawasaki Medical School, Okayama, Japan.
FAU - Takeuchi, Satoshi
AU  - Takeuchi S
AD  - Department of Obstetrics and Gynecology, Iwate Medical University, Morioka,
      Japan.
FAU - Takekuma, Munetaka
AU  - Takekuma M
AD  - Department of Gynecology, Shizuoka Cancer Center, Shizuoka, Japan.
FAU - Nagano, Tadayoshi
AU  - Nagano T
AD  - Department of Obstetrics and Gynecology, Kitano Hospital, Osaka, Japan.
FAU - Yunokawa, Mayu
AU  - Yunokawa M
AD  - Department of Breast and Medical Oncology, National Cancer Center Hospital,
      Tokyo, Japan.
FAU - Pejovic, Tanja
AU  - Pejovic T
AD  - Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Oregon
      Health & Science University, OR, USA.
FAU - Omatsu, Kohei
AU  - Omatsu K
AD  - Department of Gynecology, Cancer Institute Hospital, Tokyo, Japan.
FAU - Shahzad, Mian M K
AU  - Shahzad MMK
AD  - Division of Gynecologic Oncology, Department of Obstetrics and Gynecology,
      Moffitt Cancer Center, University of South Florida, FL, USA.
FAU - Kelley, Joseph L
AU  - Kelley JL
AD  - Division of Gynecologic Oncology, Department of Obstetrics and Gynecology,
      Magee-Womens Hospital, University of Pittsburgh, PA, USA.
FAU - Ueland, Frederick R
AU  - Ueland FR
AD  - Division of Gynecologic Oncology, Department of Obstetrics and Gynecology,
      University of Kentucky, KY, USA.
FAU - Roman, Lynda D
AU  - Roman LD
AD  - Division of Gynecologic Oncology, Department of Obstetrics and Gynecology,
      University of Southern California, CA, USA.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20171213
PL  - United States
TA  - Gynecol Oncol
JT  - Gynecologic oncology
JID - 0365304
SB  - IM
MH  - Aged
MH  - Carcinosarcoma/mortality/pathology/*surgery
MH  - Female
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Middle Aged
MH  - Neoplasm Metastasis
MH  - Neoplasm, Residual
MH  - Postoperative Complications/*etiology/mortality/pathology
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Tumor Burden
MH  - Uterine Neoplasms/mortality/pathology/*surgery
MH  - Venous Thromboembolism/*etiology/mortality
OTO - NOTNLM
OT  - *Deep vein thrombosis
OT  - *Pulmonary embolism
OT  - *Risk factors
OT  - *Survival
OT  - *Uterine carcinosarcoma
OT  - *Venous thromboembolism
EDAT- 2017/12/19 06:00
MHDA- 2018/07/03 06:00
CRDT- 2017/12/18 06:00
PHST- 2017/10/23 00:00 [received]
PHST- 2017/11/25 00:00 [revised]
PHST- 2017/11/29 00:00 [accepted]
PHST- 2017/12/19 06:00 [pubmed]
PHST- 2018/07/03 06:00 [medline]
PHST- 2017/12/18 06:00 [entrez]
AID - S0090-8258(17)31546-9 [pii]
AID - 10.1016/j.ygyno.2017.11.036 [doi]
PST - ppublish
SO  - Gynecol Oncol. 2018 Feb;148(2):267-274. doi: 10.1016/j.ygyno.2017.11.036. Epub
      2017 Dec 13.