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Prognostic Impact of the History of Breast Cancer and of Hormone Therapy in Uterine Carcinosarcoma
  1. Takashi Uehara, MD,
  2. Takashi Onda, MD, PhD,
  3. Shinichi Togami, MD,
  4. Tsukuru Amano, MD,
  5. Michihiro Tanikawa, MD,
  6. Morio Sawada, MD,
  7. Shun-ichi Ikeda, MD, PhD,
  8. Tomoyasu Kato, MD, PhD and
  9. Takahiro Kasamatsu, MD, PhD
  1. Division of Gynecologic Oncology, National Cancer Center Hospital, Tokyo, Japan.
  1. Address correspondence and reprint requests to Takashi Uehara, MD, Department of Obstetrics and Gynecology, Chiba University Hospital, Chiba University School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8677, Japan. E-mail: tak-uehara@hospital.chiba-u.jp.

Abstract

Objective Recent studies reveal an association between hormone therapy for breast cancer (BC), such as tamoxifen (TAM) and toremifene (TOR), and uterine carcinosarcoma (UCS). The aim of this study was to investigate the characteristics and prognosis of patients with UCS after BC and hormone therapy.

Methods Between January 1997 and December 2007, we treated 51 patients with UCS. The medical records of these patients were reviewed, and factors that influenced their survival were retrospectively analyzed using univariate and multivariate analyses.

Results Ten (19.6%) of the 51 patients had a history of BC; 6 (11.8%) had received hormone therapy with TAM or TOR. The characteristics of the patients with UCS were similar regardless of whether they had a history of BC or hormone therapy. On univariate analysis, age greater than 56 years, elevated serum lactate dehydrogenase levels, residual tumors, FIGO (International Federation of Gynecology and Obstetrics) stage higher than stage IIIa, and non–endometrioid carcinomatous components were identified as prognostic factors. On multivariate analysis, in addition to residual tumors, FIGO stage higher than stage IIIa, and non–endometrioid carcinomatous components, a history of BC (relative risk, 0.14), a history of TAM use (relative risk, 15.9), and a history of TOR use (relative risk, 16.9) were also identified as independently significant prognostic factors.

Conclusions Our data suggest that a history of BC and hormone therapy for BC is a risk factor for developing UCS without obvious impacts on the characteristics of UCS. Both of these factors had statistically significant impacts on the prognosis of patients with UCS. Further studies are necessary to clarify and validate these associations.

  • Uterine carcinosarcoma
  • Breast cancer
  • Tamoxifen
  • Toremifene

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Footnotes

  • The authors have no conflicts of interest to declare.

  • This study was presented in part at the 39th Annual Meeting of the Society of Gynecologic Oncologists, in Tampa, FL, on March 9–12, 2008.

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