Abstract | OBJECTIVE: To evaluate the impact of adjuvant post-operative therapy in women with early stage uterine carcinosarcoma. METHODS: After IRB approval was obtained at all sites, a multi-center retrospective study of women with FIGO stage I-II uterine carcinosarcoma diagnosed from 1997 to 2007 was conducted. Post-operative treatment included observation (OBS), radiation (RT), chemotherapy (CT) alone or with RT (CT+RT). Data analyzed included demographic and pathologic factors, adjuvant therapy outcomes, and time-to-event information. The Kaplan-Meier method was used to estimate time-to-event functions. Cox regression modeling was used to examine the impact of selected covariates on progression free survival (PFS), and overall survival (OS). RESULTS: 111 women were identified: 94 (85%) had stage I and 17 (15%) had stage II uterine carcinosarcoma. Forty-four women (40%) did not receive adjuvant therapy (OBS), 29 (26%) women had adjuvant CT, 23 (20%) women underwent RT and 15 (14%) women underwent RT+CT. Seventy-three patients were alive without disease and 38 had progressed or died at the close of data collection. In multivariate analysis, CT (p=0.003), LVSI (p<0.0001) and a pre-existing cancer (p=0.004) were most predictive of PFS. LVSI was predictive of shortened OS (p=0.01). CONCLUSIONS: In women with FIGO stage I-II uterine carcinosarcoma, adjuvant chemotherapy is associated with improved PFS compared to radiation or observation alone. Ongoing clinical trials will clarify the role of chemotherapy in women with this disease.
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Authors | Leigh A Cantrell, Laura Havrilesky, Dominic T Moore, David O'Malley, Margaret Liotta, Angeles Alvarez Secord, Christa I Nagel, David E Cohn, Amanda Nickles Fader, Amy H Wallace, Peter Rose, Paola A Gehrig |
Journal | Gynecologic oncology
(Gynecol Oncol)
Vol. 127
Issue 1
Pg. 22-6
(Oct 2012)
ISSN: 1095-6859 [Electronic] United States |
PMID | 22727985
(Publication Type: Journal Article, Multicenter Study)
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Copyright | Copyright © 2012. Published by Elsevier Inc. |
Topics |
- Aged
- Aged, 80 and over
- Carcinosarcoma
(drug therapy, pathology, radiotherapy, surgery)
- Chemoradiotherapy, Adjuvant
- Chemotherapy, Adjuvant
- Cohort Studies
- Female
- Humans
- Middle Aged
- Neoplasm Staging
- Radiotherapy, Adjuvant
- Retrospective Studies
- Risk Factors
- Survival Analysis
- Uterine Neoplasms
(drug therapy, pathology, radiotherapy, surgery)
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