RT Journal Article
SR Electronic
T1 Clinical Outcomes of Uterine Carcinosarcoma: Results of 94 Patients
JF International Journal of Gynecologic Cancer
JO Int J Gynecol Cancer
FD BMJ Publishing Group Ltd
SP 279
OP 287
DO 10.1097/IGC.0000000000000347
VO 25
IS 2
A1 Gokce, Zeynep Kestel
A1 Turan, Taner
A1 Karalok, Alper
A1 Tasci, Tolga
A1 Ureyen, Isin
A1 Ozkaya, Enis
A1 Kose, Mehmet Faruk
A1 Tulunay, Gokhan
YR 2015
UL http://ijgc.bmj.com/content/25/2/279.abstract
AB Objective We aimed to determine the clinicopathologic features and identify prognostic factors of patients with uterine carcinosarcoma.Materials and Methods A total of 94 patients with uterine carcinosarcoma who were diagnosed between January 1993 and October 2013 were included. Staging surgery consisted of total abdominal hysterectomy, bilateral salpingo-oophorectomy, pelvic and para-aortic lymphadenectomy, peritoneal cytology, and omentectomy. Staging is undertaken according to the 2009 International Federation of Gynecology and Obstetrics staging system. Kaplan-Meier survival analysis was used to determine the effects of variables on disease-free survival (DFS) and overall survival (OS).Results Seventy-nine patients underwent staging surgery and none of them had residual tumor after surgery. Three-year DFS and 3-year OS were 42.7% and 59.2%, respectively. In the univariate analysis, stage, presence of para-aortic metastatic lymph nodes, uterine serosal spread, positive peritoneal cytology, and extrapelvic metastases were associated with 3-year DFS and stage, presence of para-aortic metastatic lymph nodes, uterine serosal spread, positive peritoneal cytology, adnexal involvement, and extrapelvic metastases were associated with 3-year OS. Seventy-four patients received adjuvant therapy. Adjuvant therapy did not reduce recurrence or improve survival. Any of the chemotherapy regimens was not superior to the others. In the multivariate analysis, only age was an independent prognostic factor for 3-year DFS and no parameter was statistically significant for 3-year OS.Conclusions Age was an independent prognostic factor for 3-year DFS. Older age was associated with poor survival. Extrauterine spread was associated with survival. The aims of surgery should be both staging and providing tumoral debulking. Prospective randomized trials are needed to better define the necessity and modality of the administered adjuvant therapy.