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Significance of Lymphovascular Space Invasion by the Sarcomatous Component in Uterine Carcinosarcoma.
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; Enomoto, Takayuki; 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, CA, USA. 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, Pittsburgh, PA, USA.
  • Elishaev E; Department of Pathology, MaGee-Womens Hospital, University of Pittsburgh, Pittsburgh, PA, USA.
  • Yunokawa M; Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.
  • Sheridan TB; Department of Pathology, Mercy Medical Center, Baltimore, MD, USA.
  • Bush SH; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Moffitt Cancer Center, University of South Florida, Tampa, FL, USA.
  • Klobocista MM; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Albert Einstein College of Medicine, Montefiore Medical Center, New York, NY, USA.
  • Blake EA; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Colorado, Boulder, CO, 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 Medical Center, Lexington, KY, USA.
  • Yoshida M; Department of Pathology, National Cancer Center Hospital, Tokyo, Japan.
  • Hakam A; Department of Pathology, Moffitt Cancer Center, University of South Florida, Tampa, FL, USA.
  • Machida H; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA.
  • Mhawech-Fauceglia P; Department of Pathology, University of Southern California, Los Angeles, CA, 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, Portland, OR, 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, Portland, OR, 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, Boulder, CO, USA.
  • Post MD; Department of Pathology, University of Colorado, Boulder, CO, USA.
  • Shahzad MMK; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Moffitt Cancer Center, University of South Florida, Tampa, FL, USA.
  • Im DD; Department of Gynecology, Mercy Medical Center, Baltimore, MD, USA.
  • Yoshida H; Department of Pathology, National Cancer Center Hospital, Tokyo, Japan.
  • Enomoto T; Department of Obstetrics and Gynecology, Niigata University, Niigata, 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 Medical Center, Lexington, KY, USA.
  • Kelley JL; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, MaGee-Womens Hospital, University of Pittsburgh, Pittsburgh, PA, USA.
  • Karabakhtsian RG; Department of Pathology, University of Kentucky Medical Center, Lexington, KY, USA.
  • Roman LD; Department of Pathology, Albert Einstein College of Medicine, Montefiore Medical Center, New York, NY, USA.
Ann Surg Oncol ; 25(9): 2756-2766, 2018 Sep.
Article em En | MEDLINE | ID: mdl-29971677
ABSTRACT

OBJECTIVE:

The aim of this study was to examine the significance of lymphovascular space invasion (LVSI) with a sarcomatous component on the tumor characteristics and clinical outcomes of women with uterine carcinosarcoma (UCS).

METHODS:

This was a secondary analysis of a prior multicenter retrospective study that examined women with stage I-IV UCS who underwent primary hysterectomy. Archived histopathology slides were reviewed and LVSI was scored as follows LVSI with a carcinomatous component alone (LVSI-carcinoma; n = 375, 76.8%) or LVSI containing a sarcomatous component with or without a carcinomatous component (LVSI-sarcoma; n = 113, 23.2%). Qualitative metrics of LVSI were correlated to clinicopathological factors and survival outcome.

RESULTS:

Tumors in the LVSI-sarcoma group were more likely to have sarcoma dominance (82.1 vs. 26.4%) heterologous sarcomatous component (51.3 vs. 37.9%), low-grade carcinoma (42.5 vs. 22.4%), and large tumor size (81.0 vs. 70.2%) in the primary tumor site compared with tumors in the LVSI-carcinoma group (all p < 0.05). On multivariate analysis, LVSI-sarcoma was independently associated with decreased progression-free survival (5-year rates 34.9 vs. 40.8%, adjusted hazard ratio [HR] 1.84, 95% confidence interval [CI] 1.36-2.50, p < 0.001), and cause-specific survival (5-year rates 41.8 vs. 55.9%, adjusted HR 1.95, 95% CI 1.39-2.75, p < 0.001) compared with LVSI-carcinoma. Postoperative radiotherapy for women with LVSI-sarcoma had a higher reduction rate of recurrence/progression of disease (54% reduction, p = 0.04) compared with postoperative radiotherapy for women with LVSI-carcinoma (26% reduction, p = 0.08).

CONCLUSION:

In UCS, the presence of a sarcomatous component in LVSI is particularly prevalent when a tumor has sarcoma dominance. Our study suggests that LVSI containing a sarcomatous component may be a predictor of decreased survival for women with UCS.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Uterinas / Vasos Sanguíneos / Carcinossarcoma / Vasos Linfáticos Tipo de estudo: Observational_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Limite: Female / Humans / Middle aged Idioma: En Ano de publicação: 2018 Tipo de documento: Article
Texto completo
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Uterinas / Vasos Sanguíneos / Carcinossarcoma / Vasos Linfáticos Tipo de estudo: Observational_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Limite: Female / Humans / Middle aged Idioma: En Ano de publicação: 2018 Tipo de documento: Article