Tumor characteristics and outcome of uterine carcinosarcoma in women aged ≥80 years.
Surg Oncol
; 29: 25-32, 2019 Jun.
Article
em En
| MEDLINE
| ID: mdl-31196490
ABSTRACT
OBJECTIVE:
To examine clinico-pathological characteristics and outcomes of uterine carcinosarcoma (UCS) in women aged ≥80 years.METHODS:
This is a secondary analysis of a previous multicenter retrospective study examining 906 women with stage I-IV UCS who underwent primary hysterectomy. Patient demographics, treatment types, tumor characteristics, and survival were examined across aged ≥80 (nâ¯=â¯82 [9.1%]), aged 60-79, (nâ¯=â¯526 [58.1%]), and aged <60 (nâ¯=â¯298 [32.9%]).RESULTS:
Women in the aged ≥80 group were more likely to be Caucasian, undergo simple hysterectomy without lymphadenectomy, and receive no postoperative therapy (all, Pâ¯<â¯0.05). Tumors in the aged ≥80 group were more likely to have high-grade carcinoma, heterologous sarcoma, and sarcoma dominance but less likely to have lympho-vascular space invasion (all, Pâ¯<â¯0.05). Lymphadenectomy did not improve survival in the aged ≥80 group (Pâ¯>â¯0.05), whereas lymphadenectomy was protective for survival in the younger groups (both, Pâ¯<â¯0.05). Postoperative chemotherapy was associated with improved progression-free survival (PFS) in the aged ≥80 group (hazard ratio [HR] 0.44, 95% confidence interval [CI] 0.22-0.89, Pâ¯=â¯0.021). With chemotherapy treatment, women in the aged ≥80 group had PFS similar to those in the aged 60-79 group (HR 0.97, 95%CI 0.51-1.83, Pâ¯=â¯0.92). In contrast, without chemotherapy treatment, women in the aged ≥80 group had significantly decreased PFS compared to the aged 60-79 group (HR 1.62, 95%CI 1.09-2.40, Pâ¯=â¯0.016). Similar associations were observed for postoperative radiotherapy.CONCLUSION:
Nearly 10% of women with UCS are aged ≥80 that are characterized by aggressive tumor factors. Postoperative therapy but not extensive surgery may improve survival in this age group.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Uterinas
/
Carcinossarcoma
/
Quimioterapia Adjuvante
/
Radioterapia Adjuvante
/
Histerectomia
/
Excisão de Linfonodo
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article