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Characterizing sarcoma dominance pattern in uterine carcinosarcoma: Homologous versus heterologous element.
Matsuo, Koji; Takazawa, Yutaka; Ross, Malcolm S; Elishaev, Esther; Yunokawa, Mayu; Sheridan, Todd B; Bush, Stephen H; Klobocista, Merieme M; Blake, Erin A; Takano, Tadao; Baba, Tsukasa; Satoh, Shinya; Shida, Masako; Ikeda, Yuji; Adachi, Sosuke; Yokoyama, Takuhei; Takekuma, Munetaka; Yanai, Shiori; Takeuchi, Satoshi; Nishimura, Masato; Iwasaki, Keita; Johnson, Marian S; Yoshida, Masayuki; Hakam, Ardeshir; Machida, Hiroko; Mhawech-Fauceglia, Paulette; Ueda, Yutaka; Yoshino, Kiyoshi; Kajiwara, Hiroshi; Hasegawa, Kosei; Yasuda, Masanori; Miyake, Takahito M; Moriya, Takuya; Yuba, Yoshiaki; Morgan, Terry; Fukagawa, Tomoyuki; Pejovic, Tanja; Nagano, Tadayoshi; Sasaki, Takeshi; Richmond, Abby M; Post, Miriam D; Shahzad, Mian M K; Im, Dwight D; Yoshida, Hiroshi; Omatsu, Kohei; Ueland, Frederick R; Kelley, Joseph L; Karabakhtsian, Rouzan G; Roman, Lynda D.
Afiliação
  • Matsuo K; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, USA. Electronic address: koji.matsuo@med.usc.edu.
  • Takazawa Y; Department of Pathology, Cancer Institute Hospital, Tokyo, Japan.
  • Ross MS; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, MaGee-Womens Hospital, University of Pittsburgh, USA.
  • Elishaev E; Department of Pathology, MaGee-Womens Hospital, University of Pittsburgh, USA.
  • Yunokawa M; Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.
  • Sheridan TB; Department of Pathology, Mercy Medical Center, Baltimore, USA.
  • Bush SH; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Moffitt Cancer Center, University of South Florida, USA.
  • Klobocista MM; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Albert Einstein College of Medicine, Montefiore Medical Center, USA.
  • Blake EA; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Colorado, USA.
  • Takano T; Department of Obstetrics and Gynecology, Tohoku University, Miyagi, Japan.
  • Baba T; Department of Obstetrics and Gynecology, Kyoto University, Kyoto, Japan.
  • Satoh S; Department of Obstetrics and Gynecology, Tottori University, Tottori, Japan.
  • Shida M; Department of Obstetrics and Gynecology, Tokai University, Kanagawa, Japan.
  • Ikeda Y; Department of Obstetrics and Gynecology, The University of Tokyo, Tokyo, Japan.
  • Adachi S; Department of Obstetrics and Gynecology, Niigata University, Niigata, Japan.
  • Yokoyama T; Department of Obstetrics and Gynecology, Osaka Rosai Hospital, Osaka, Japan.
  • Takekuma M; Department of Gynecology, Shizuoka Cancer Center, Shizuoka, Japan.
  • Yanai S; Department of Obstetrics and Gynecology, Kurashiki Medical Center, Okayama, Japan.
  • Takeuchi S; Department of Obstetrics and Gynecology, Iwate Medical University, Morioka, Japan.
  • Nishimura M; Department of Obstetrics and Gynecology, Tokushima University, Tokushima, Japan.
  • Iwasaki K; Department of Obstetrics and Gynecology, Aichi Medical University, Aichi, Japan.
  • Johnson MS; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky, USA.
  • Yoshida M; Department of Pathology, National Cancer Center Hospital, Tokyo, Japan.
  • Hakam A; Department of Pathology, Moffitt Cancer Center, University of South Florida, USA.
  • Machida H; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, USA.
  • Mhawech-Fauceglia P; Department of Pathology, University of Southern California, Los Angeles, USA.
  • Ueda Y; Department of Obstetrics and Gynecology, Osaka University, Osaka, Japan.
  • Yoshino K; Department of Obstetrics and Gynecology, Osaka University, Osaka, Japan.
  • Kajiwara H; Department of Pathology, Tokai University, Kanagawa, Japan.
  • Hasegawa K; Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama, Japan.
  • Yasuda M; Department of Pathology, Saitama Medical University International Medical Center, Saitama, Japan.
  • Miyake TM; Department of Obstetrics and Gynecology, Kawasaki Medical School, Okayama, Japan.
  • Moriya T; Department of Pathology, Kawasaki Medical School, Okayama, Japan.
  • Yuba Y; Department of Pathology, Kitano Hospital, Osaka, Japan.
  • Morgan T; Department of Pathology, Oregon Health & Science University, USA.
  • Fukagawa T; Department of Pathology, Iwate Medical University, Morioka, Japan.
  • Pejovic T; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Oregon Health & Science University, USA.
  • Nagano T; Department of Obstetrics and Gynecology, Kitano Hospital, Osaka, Japan.
  • Sasaki T; Department of Pathology, The University of Tokyo, Tokyo, Japan.
  • Richmond AM; Department of Pathology, University of Colorado, USA.
  • Post MD; Department of Pathology, University of Colorado, USA.
  • Shahzad MMK; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Moffitt Cancer Center, University of South Florida, USA.
  • Im DD; Department of Gynecology, Mercy Medical Center, Baltimore, USA.
  • Yoshida H; Department of Pathology, National Cancer Center Hospital, Tokyo, Japan.
  • Omatsu K; Department of Gynecology, Cancer Institute Hospital, Tokyo, Japan.
  • Ueland FR; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky, USA.
  • Kelley JL; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, MaGee-Womens Hospital, University of Pittsburgh, USA.
  • Karabakhtsian RG; Department of Pathology, University of Kentucky, USA; Department of Pathology, Albert Einstein College of Medicine, Montefiore Medical Center, USA.
  • Roman LD; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, USA.
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, n = 351), heterologous sarcoma without SD (hetero/non-dominance, n = 174), homologous sarcoma with SD (homo/dominance, n = 175), and heterologous sarcoma with SD (hetero/dominance, n = 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, P < 0.05). On univariate analysis, SD was associated with decreased progression-free survival (PFS) and cause-specific survival (CSS) in homologous cases (both, P < 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, P < 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, P < 0.05); contrary, this association was not observed with absence of SD (all, P > 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.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Uterinas / Carcinossarcoma / Neoplasias do Endométrio / Cistadenocarcinoma Seroso / Adenocarcinoma de Células Claras Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Male / Middle aged Idioma: En Revista: Surg Oncol Assunto da revista: NEOPLASIAS Ano de publicação: 2018 Tipo de documento: Article
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Uterinas / Carcinossarcoma / Neoplasias do Endométrio / Cistadenocarcinoma Seroso / Adenocarcinoma de Células Claras Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Male / Middle aged Idioma: En Revista: Surg Oncol Assunto da revista: NEOPLASIAS Ano de publicação: 2018 Tipo de documento: Article