Prognostic factors for disease-free and overall survival of patients with uterine carcinosarcoma
- 177 Downloads
Uterine carcinosarcoma (UCS) is a relatively rare and very aggressive tumor. The predictors of survival for patients with UCS have not been determined clearly yet. The aim of the present study was to investigate the possible predictors of disease-free survival (DFS) and overall survival (OS) for patients with UCS.
Methods and materials
All patients with UCS who were treated surgically at a university-based Gynecology Oncology Clinic between January 2008 and December 2014 were recruited into this retrospective cohort study. Data regarding clinical, pathologic and treatment information were obtained retrospectively from hospital records. The Kaplan–Meier method was used to calculate DFS and OS, and Cox regression analysis was performed to define the effects of risk factors on survival.
A total of 88 UCS patients with a median age of 64.5 years were included in the study. Forty-seven (53.4%) patients were diagnosed with stage III disease and seven (7.9%) with stage IV disease. The median follow-up time was 16 months. Among all patients, 60 (68.1%) underwent lymphadenectomy. Optimal cytoreductive surgery was achieved in 67 (76.1%) patients. Stepwise variable selection Cox regression analysis showed that lymph node metastasis was associated with poor DFS (hazard ratio 6.524; 95% CI 2.625–16.211; P < 0.001) and OS (hazard ratio 6.993; 95% CI 2.631–18.587; P < 0.001). Subgroup analysis in both early and advanced-stage diseases revealed no significant impact of risk factors on survival.
Lymph node metastasis is the most significant prognostic factor associated with poor DFS and OS in UCS patients.
KeywordsLymphadenectomy Lymph node metastasis Residual tumor Survival Uterine carcinosarcoma
YES: data management, manuscript writing/editing; ST: protocol/project development, interpretation, management; BV: data collection; CA: data analysis; MG: interpretation, critical reviews; FO: interpretation, critical reviews.
Compliance with ethical standards
Conflict of interest
The authors of this article report no conflict of interest.
All procedures performed were in accordance with the ethical standards of the institutional review board and with the Helsinki declaration or comparable ethical standards.
- 22.Wolfson AH, Brady MF, Rocereto T et al (2007) A gynecologic oncology group randomized phase III trial of whole abdominal irradiation (WAI) vs. cisplatin-ifosfamide and mesna (CIM) as post-surgical therapy in stage I–IV carcinosarcoma (CS) of the uterus. Gynecol Oncol 107:177–185CrossRefPubMedPubMedCentralGoogle Scholar
- 23.Reed NS, Mangioni C, Malmström H et al (2008) Phase III randomised study to evaluate the role of adjuvant pelvic radiotherapy in the treatment of uterine sarcomas stages I and II: a European Organisation for Research and Treatment of Cancer Gynaecological Cancer Group Study (protocol 55874). Eur J Cancer 44:808–818CrossRefPubMedGoogle Scholar