A multi-institutional study of outcomes in stage I-III uterine carcinosarcoma

Gynecologic Oncology
Elizabeth L DicksonMelissa A Geller

Abstract

To evaluate the use of adjuvant therapy after primary surgery for stage I-III uterine carcinosarcoma (CS). A multi-institutional retrospective study of women with stage I-III CS was conducted. Analyses were stratified by stage (I/II and III). Patients were categorized according to adjuvant therapy: observation (OBS), radiation (RT), chemotherapy (CT) or multimodal therapy (CT+RT). Overall survival (OS) and progression-free survival (PFS) were analyzed using log-rank tests and Cox proportional hazards models. 303 patients were identified across four institutions: 195 with stage I/II and 108 with stage III disease. In stage I/II disease, 75 (39.9%) received OBS, 33 (17.6%) CT, 37 (19.7%) RT, and 43 (22.9%) CT+RT. OBS was associated with a fourfold increased risk of death compared to CT (adjusted hazard ratio (aHR)=4.48, p=0.003). Patients receiving CT+RT had significantly improved PFS compared to those receiving CT alone (aHR=0.43, p=0.04), but no difference in OS. In the stage III cohort, 16 (15.0%) received OBS, 34 (31.8%) CT, 20 (18.7%) RT, and 37 (34.6%) CT+RT. OBS was associated with worse OS and PFS compared to CT (OS: aHR=2.46, p=0.04; PFS: aHR=2.39, p=0.03, respectively). A potential improvement in PFS was seen for those ...Continue Reading

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Citations

Jan 26, 2017·American Journal of Clinical Oncology·Bismarck OdeiDavid K Gaffney
Jun 28, 2017·American Journal of Clinical Oncology·William A StokesChristine M Fisher
Jun 3, 2017·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·Andrew T WongDavid Schreiber
Apr 29, 2019·Abdominal Radiology·Pavitra RavishankarNikhil H Ramaiya
Jan 18, 2020·Cancer Chemotherapy and Pharmacology·César Gómez-RaposoEnrique Casado Saenz
Apr 30, 2021·The Journal of Obstetrics and Gynaecology Research·Fei ZhaoAiping Chen
May 26, 2021·Gynecologic Oncology·Michael D ToboniPremal H Thaker
Jun 19, 2021·Cancer Management and Research·Kerri BeckmannMartin K Oehler

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