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EP171/#796  The need for lymph node evaluation in late-stage uterine carcinosarcoma – a multicenter retrospective study
  1. Yaokai Wang1,
  2. Juan Peng2,
  3. Lizhou Liu3,
  4. Bei Liu1,
  5. Xian Li1,
  6. Suk Lau4,5,
  7. Shuk Kwok4,5,
  8. Mandy Chu4,5,
  9. Siew Fei Ngu4,5,
  10. Karen Chan1,4,5,
  11. Li Zhang1,
  12. Hextan Ngan1,4,5 and
  13. Ka Tse1,4,5
  1. 1the University of Hong Kong-Shenzhen Hospital, Gynecology and Obstetrics, Guangdong, China
  2. 2the Third Affiliated Hospital of Zhengzhou University, Department of Obstetrics and Gynecology, Zhengzhou, China
  3. 3Shenzhen Maternal and Child Health Care Hospital, Department of Obstetrics and Gynecology, Shenzhen, China
  4. 4School of Clinical Medicine, the University of Hong Kong, Department of Obstetrics and Gynecology, Hongkong, China
  5. 5Queen Mary Hospital, Department of Obstetrics and Gynecology, Hongkong, China


Introduction Uterine carcinosarcoma (UCS) is a highly aggressive, rare, biphasic tumor.Lymph node evaluation by either lymphadenectomy (LND) or sentinel lymph node biopsy(SLNB) is recommended. However, its value in late-stage disease remains unclear.

Methods Clinical data of patients with UCS from four different hospitals between February 2006 and December 2021 were reviewed. Patients with prior radiotherapy and/or chemotherapy were excluded. Progression-free survival (PFS) and overall survival (OS) were determined.

Results Among 103 UCS patients, 91 UCS patients had enough follow-up data. 47 (51.6%) were diagnosed at stage III-IV, among which 24 (51.1%) had LND. 16 patients (34.0%) had lymph node metastases (LNM). Patients undergoing LND was associated with longer median PFS (20.2 months vs. 5.7 months, P = 0.009) and OS (29.1 months vs. 14.1 months, P < 0.009) compared to those without LND. Multivariate analyses demonstrated that LND (hazard ratio, HR 0.447, 95% confidence interval (CI) 0.23 – 0.86, P = 0.-16) and chemotherapy (HR 0.070, 95% CI 0.03 – 0.19, P < 0.001) were significant prognostic factors for PFS in late-stage patients. Additionally, LND (HR 0.133, 95% CI 0.04 – 0.50, P =0.003) and chemotherapy (HR 0.102, 95% CI 0.03 – 0.33, P < 0.001) were independent significant prognostic factors for OS.

Conclusion/Implications Despite the use of adjuvant therapy, LND remains an integral part of the surgical treatment. Further prospective studies are needed to elucidate its value in late-stage disease.

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