Patterns of adjuvant treatment and survival outcomes in stage I uterine carcinosarcoma

Cory, Lori; Brensinger, Colleen M.; Burger, Robert A.; Giuntoli, Robert L.; Morgan, Mark A.; Latif, Nawar; Lin, Lilie L.; Ko, Emily

doi:10.1016/j.gore.2022.100930

Cited by 5 publications

(1 citation statement)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The variability in the reported treatment regimens and outcomes in the literature demonstrates a lack of consensus for carcinosarcoma patients. Early-stage studies indicate that the 5-year survival for stage I uterine carcinosarcoma may be as low as 43% without adjuvant therapy [5]; however, other studies have reported that patients may perform well with only surveillance [2]. Balancing sufficient treatment with an avoidance of potential toxicities is therefore extremely challenging, and recurrences are generally fatal [3].…”

Section: Introductionmentioning

confidence: 99%

Non-Metastatic Uterine Carcinosarcoma: A Tailored Approach or One Size Fits All?

Maione,

Sienna,

Schnarr

et al. 2024

Radiation

View full text Add to dashboard Cite

Purpose: Uterine carcinosarcomas are highly aggressive tumors of the endometrium and are associated with a poor prognosis. The optimal adjuvant treatment for both early and advanced-stage patients remains unclear. Methods: Cases of uterine carcinosarcoma were identified in our institution’s pathology database between 2000 and 2022. Kaplan–Meier estimates were calculated for the local and distant recurrence-free, disease-free and overall survival; hazard ratios were calculated using Cox proportional hazards modelling for independent prognostic factors including the stage and treatment. Results: A total of 48 patients were identified as having uterine carcinosarcoma, of whom 70.8% were surgically staged. In total, 43 patients had pelvic-confined disease, while five had positive omental or peritoneal biopsies at surgery. There were 10 pelvic (20.8%) and 19 (39.6%) distant recurrences. None of the patients with stage IA disease who received chemotherapy and brachytherapy experienced disease recurrence. The local recurrence-free survival was 54.95%, the distant recurrence-free survival was 44.7%, and the overall survival was 59.6% at 5 years. Local recurrence-free survival and overall survival were inversely associated with advanced-stage OR 1.23 (p = 0.005) and OR 1.28 (p = 0.017), respectively, and no chemotherapy was associated with OR 1.96 (p = 0.06) and OR 2.08 (p = 0.056), respectively. Conclusion: The local and distant recurrence rates were high for advanced=stage patients even when treated with aggressive adjuvant therapy regimens. Chemotherapy may improve recurrence and survival. Early-stage patients may perform well with vaginal vault brachytherapy and chemotherapy. Further prospective comparisons are required between sequential, sandwich, and concurrent approaches to chemotherapy and radiotherapy, to optimize outcomes in this high-risk population.

show abstract

Section: Introductionmentioning

confidence: 99%

Non-Metastatic Uterine Carcinosarcoma: A Tailored Approach or One Size Fits All?

Maione,

Sienna,

Schnarr

et al. 2024

Radiation

View full text Add to dashboard Cite

show abstract

Secondary databases in gynecologic cancer research

Hicks-Courant,

Ko,

Matsuo

et al. 2024

Int J Gynecol Cancer

View full text Add to dashboard Cite

Observational and cohort studies using large databases have made important contributions to gynecologic oncology. Knowledge of the advantages and potential limitations of commonly used databases benefits both readers and reviewers. In this review, researchers familiar with National Cancer Database (NCDB), Surveillance, Epidemiology, and End Results Program (SEER), SEER-Medicare, MarketScan, Healthcare Cost and Utilization Project (HCUP), National Surgical Quality Improvement Program (NSQIP), and Premier, describe each database, its included data, access, management, storage, highlights, and limitations. A better understanding of these commonly used datasets can help readers, reviewers, and researchers to more effectively interpret and apply study results, evaluate new research studies, and develop compelling and practice-changing research.

show abstract

Survival analysis of patients with rare tumors of the uterine corpus – carcinosarcoma

Stevanovic,

Mandic,

Maricic

et al. 2024

VOJNOSANIT PREGL

View full text Add to dashboard Cite

Background/Aim. Carcinosarcoma of the uterus, formerly known as malignant mixed M?llerian tumor, is a rare, aggressive malignancy of the female genital tract. The aim of this study was to analyse most important clinical and pathohistological characteristics of carcinosarcomas on operated patients, as well as to determine which of those factors are affecting disease free survival and overall survival of patients. Methods. The study was conducted as a retrospective analysis of medical data documentation of patients with a diagnosis of carcinosarcoma of the uterus who were surgically treated at Department of Gynecology, Clinic for Operative Oncology, Oncology Institute of Vojvodina, Sremska Kamenica, Serbia, in a period of 10 years, from the beginning of 2009 to the end of 2018. Results. The analysis included data for a total of 31 patients. Of all the examined parameters (age of the patient, clinical stage of the disease, histological grade, depth of myometrial invasion and lymphovascular invasion) the greatest influence on the choice of therapeutic procedure had a histological tumor grade. Conclusion. Our research showed the joint influence of the examined clinical and pathohistological factors parameters on progressionfree survival (PFS) and overall survival (OS) of patients with carcinosarcoma of the uterus. The only independent parameter that showed statistically significant impact on survival is lymphovascular invasion.

show abstract

Patterns of adjuvant treatment and survival outcomes in stage I uterine carcinosarcoma

Abstract: Highlights 5-year survival for stage I uterine carcinosarcoma without adjuvant therapy is 43%. Nationally 40% of stage I uterine carcinosarcoma do not receive adjuvant therapy. Adjuvant chemotherapy alone improved OS and CSS in stage I uterine carcinosarcoma.

Cited by 5 publications

References 20 publications

Non-Metastatic Uterine Carcinosarcoma: A Tailored Approach or One Size Fits All?

Non-Metastatic Uterine Carcinosarcoma: A Tailored Approach or One Size Fits All?

Secondary databases in gynecologic cancer research

Survival analysis of patients with rare tumors of the uterine corpus – carcinosarcoma

Contact Info

Product

Resources

About