Characterizing sarcoma dominance pattern in uterine carcinosarcoma: Homologous versus heterologous element.
Surg Oncol
; 27(3): 433-440, 2018 Sep.
Article
em En
| MEDLINE
| ID: mdl-30217299
ABSTRACT
OBJECTIVE:
To examine significance of sarcoma dominance (SD) patterns in uterine carcinosarcoma (UCS).METHODS:
This is a secondary analysis of multicenter retrospective study examining women with stages I-IV UCS who underwent primary surgery. SD was defined as >50% of sarcoma component in uterine tumor. SD patterns were grouped as homologous sarcoma without SD (homo/non-dominance, nâ¯=â¯351), heterologous sarcoma without SD (hetero/non-dominance, nâ¯=â¯174), homologous sarcoma with SD (homo/dominance, nâ¯=â¯175), and heterologous sarcoma with SD (hetero/dominance, nâ¯=â¯189), and correlated to tumor characteristics and survival.RESULTS:
SD patterns were significantly associated with age, body habitus, carcinoma type, tumor size, depth of myometrial invasion, and nodal metastasis (all, Pâ¯<â¯0.05). On univariate analysis, SD was associated with decreased progression-free survival (PFS) and cause-specific survival (CSS) in homologous cases (both, Pâ¯<â¯0.05) but not in heterologous cases. On multivariate models, both homologous and heterologous SD patterns remained independent prognostic factors for decreased PFS (adjusted-hazard ratio [HR] ranges homo/dominance 1.35-1.69, and hetero/dominance 1.47-1.64) and CSS (adjusted-HR ranges 1.52-1.84 and 1.66-1.81, respectively) compared to homo/non-dominance (all, Pâ¯<â¯0.05). Among stage I-III disease, when tumors had SD, adding radiotherapy to chemotherapy was significantly associated with improved PFS (adjusted-HR homo/dominance 0.49, and hetero/dominance 0.45) and CSS (0.36 and 0.31, respectively) compared to chemotherapy alone (all, Pâ¯<â¯0.05); contrary, this association was not observed with absence of SD (all, Pâ¯>â¯0.05).CONCLUSION:
In UCS, SD impacts survival in homologous but not in heterologous type. Regardless of sarcoma types, SD was associated with decreased survival in UCS; adding radiotherapy to chemotherapy may be an effective postoperative strategy.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Uterinas
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Carcinossarcoma
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Neoplasias do Endométrio
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Cistadenocarcinoma Seroso
/
Adenocarcinoma de Células Claras
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
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Male
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Middle aged
Idioma:
En
Revista:
Surg Oncol
Assunto da revista:
NEOPLASIAS
Ano de publicação:
2018
Tipo de documento:
Article