Prognostic factors for disease-free and overall survival of patients with uterine carcinosarcoma

Şükür, Yavuz Emre; Taşkın, Salih; Varlı, Bulut; Ateş, Can; Güngör, Mete; Ortaç, Fırat

doi:10.1007/s10147-017-1181-3

Cited by 11 publications

(7 citation statements)

References 22 publications

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“…A percentage range of 40-46 and 30-45% has been reported for leiomyosarcomas carcinosarcomas, respectively. In contrast to these findings, the range and percentage was estimated to 86-97% for ESSs and to 69% for adenosarcomas, respectively (20,(26)(27)(28). The rates reported in the present study were lower than those previously published.…”

Section: Uterine Sarcomas By Histological Type ----------------------contrasting

confidence: 99%

Diagnosis, treatment and survival of uterine sarcoma: A retrospective cohort study of 122 cases

et al. 2020

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The present study aimed to assess the diagnosis, treatment and follow-up of uterine sarcoma cases. A retrospective cohort study with 122 women recruited between 2001 and 2016 was performed. The data regarding epidemiology, clinical presentation, treatment and follow-up were analyzed based on the following histological types: Carcinosarcoma, leiomyosarcoma, endometrial stromal sarcoma (ESS) and adenosarcoma. Statistical analysis included descriptive statistics, logistic regression and survival curves. The diagnosis of uterine sarcoma exhibited an increasing trend of +1.2 new cases every 2 years (P=0.044) and comprised 10% of all uterine cancer diagnoses. There were 47% carcinosarcomas, 22% leiomyosarcomas, 16% ESS and 14% adenosarcomas. The majority of the women was ≥60 years old (62%). Among the subjects, 77% were postmenopausal, 61% had a body mass index up to 29.9 kg/m 2 and 71% presented with a comorbidity. Regression analysis exhibited an association between post menopause and the histological type associated with lower overall survival (OS), namely leiomyosarcoma or carcinosarcoma (odds ratio, 5.45, P<0.001). Stage I malignancy was present in 44% and Stage IV in 22%. The treatment included primary surgery in 78% of the cases, whereas 79% received adjuvant therapy. Only 55 cases achieved disease control and 20 relapsed (36%) with a 5-year OS rate of 33%. The OS was lower for carcinosarcoma and leiomyosarcoma (20%; P=0.003). In summary, the present study indicated that the number of uterine sarcoma cases had increased between 2001 and 2016. The majority of the women were >60 years old and diagnosed in advanced stages. The postmenopausal status was associated with histological types of poor prognosis. The OS was low and worse for patients with carcinosarcoma and leiomyosarcoma.

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Section: Uterine Sarcomas By Histological Type ----------------------contrasting

confidence: 99%

Diagnosis, treatment and survival of uterine sarcoma: A retrospective cohort study of 122 cases

et al. 2020

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“…However, a study published by Şükür et al demonstrated that LNM was the most important predictor of UCS survival in a multivariate analysis. 19 The Cox model identified an independent negative association between older age and OS but not CSS, which suggests that the elderly with OCS may die of other diseases or causes rather than OCS. Subgroup analysis revealed that LNM had an impact on CSS and OS in AJCC T2 (CSS, HR = 3.62, 95% CI = 1.50–8.73; OS, HR = 3.71, 95% CI = 1.59–8.68) but not AJCC T1 (CSS, HR = 1.78, 95% CI = 0.50–6.37; OS, HR = 1.97, 95% CI = 0.61–6.39).…”

Section: Discussionmentioning

confidence: 91%

Prognostic significance of lymph node metastasis and lymphadenectomy in early-stage ovarian carcinosarcoma

Wang

Zhang

et al. 2018

CMAR

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BackgroundThe role that lymph node dissection (LND) plays in the management of ovarian carcinosarcoma (OCS) is unclear due to its rarity. This study investigated lymph node metastasis (LNM) prevalence in women with early OCS and effects of LND and LNM on survival.MethodsData of women diagnosed with OCS, whose primary tumor was confined to ovaries (American Joint Committee on Cancer [AJCC] T1) or pelvic cavity (AJCC T2), between 1988 and 2010 were collected from the Surveillance, Epidemiology, and End Results (SEER) database. Patients were classified into lymphadenectomy (LND [+]) and no lymphadenectomy (LND [−]) groups.ResultsA total of 363 women were included. The prevalence of LNM was 9.6% in AJCC T1 and 16.3% in AJCC T2. Multivariate analysis showed that LND and AJCC T categories were independent prognostic variables, irrespective of cancer-specific survival (CSS) or overall survival (OS). Subgroup analysis by AJCC T categories revealed that LND (+) group in AJCC T2 had a better survival outcome compared to LND (−) group (CSS, HR [95% CI] = 0.61 [0.43–0.87]; OS, HR [95% CI] = 0.59 [0.42–0.83]). There was no survival difference between groups in AJCC T1 (CSS, HR [95% CI] = 0.96 [0.56–1.65]; OS, HR [95% CI] = 0.88 [0.56–1.38]). Multivariate analysis was further carried out in LND (+) group and demonstrated that LNM and AJCC T2 had poor CSS and OS. Subgroup analysis by AJCC T categories showed that worse survival was observed in LNM (+) group compared to LNM (−) group in AJCC T2 (CSS, HR [95% CI] = 3.62 [1.50–8.73]; OS, HR [95% CI] = 3.71 [1.59–8.68]) but not in AJCC T1 (CSS, HR [95% CI] = 1.78 [0.50–6.37]; OS, HR [95% CI] = 1.97 [0.61–6.39]).ConclusionRegional lymphadenectomy should be performed in patients with AJCC T2 OCS. LND and LNM were not significantly associated with prognosis in AJCC T1 while LNM had a trend toward worse survival.

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“…Chen et al evaluated 81 patients and reported that advanced age was a significantly worse prognostic factor in terms of both OS and PFS 20 . There are also studies in the literature stating that age has no prognostic value in carcinosarcomas [11][12][13] . Worse DFS in advanced age could be attributed to the better response to adjuvant treatment in younger patients.…”

Section: Discussionmentioning

confidence: 99%

“…Rhabdomyosarcoma is the most common heterologous component, followed by chondrosarcoma, osteosarcoma, and liposarcoma 1 . A consensus has emerged in UC regarding some prognostic factors such as stage, lymphadenectomy, residual disease, and adjuvant therapy that affect survival 6 , 10 , 12 , 13 . In this study, which was conducted in a tertiary reference center with more than 20 years of experience in the field of gynecological oncology, we found that the presence of a heterologous component in UC shortened both OS and DFS compared with the presence of a homologous component.…”

Section: Discussionmentioning

confidence: 99%

The prognostic significance of the heterologous component in uterine carcinosarcomas

Can,

Karataşli,

Çakir

et al. 2023

Rev. Assoc. Med. Bras.

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OBJECTIVE: Uterine carcinosarcomas are aggressive, rare biphasic tumors with malignant epithelial and malignant sarcomatous components. The prognostic significance of the presence of extrauterine sarcoma (heterologous component) is controversial. Therefore, the aim of this study was to investigate the effect of heterologous components in uterine carcinosarcomas on disease-free survival, overall survival, and other prognostic factors. METHODS: Clinical and histopathological data from patients treated for uterine carcinosarcoma in a tertiary cancer center in Turkey between July 2000 and January 2020 were collected. Independent risk factors affecting overall survival and disease-free survival were analyzed by univariate and multivariate Cox regression analyses. RESULTS: A total of 98 patients were identified. The median follow-up was 21.8 (1.2-233.1) months. In the multivariate analysis, the median overall survival and disease-free survival were 23.8 and 20.7 months in those with homologous mesenchymal components and 17.6 and 9.7 months in those with heterologous mesenchymal components, respectively. It was found that the presence of heterologous mesenchymal components significantly reduced both overall survival and disease-free survival (odds ratio [OR], 2.861; 95% confidence interval p=0.018 and OR, 3.697; p=0.003, respectively). In addition, both lymphadenectomy and adjuvant radiotherapy were found to significantly increase overall survival and disease-free survival. Age was found to increase only disease-free survival. CONCLUSION: The results obtained in this study showed that the presence of heterologous components in uterine carcinosarcoma is a prognostic factor that adversely affects both overall survival and disease-free survival. Lymphadenectomy and adjuvant radiotherapy have beneficial effects on both overall survival and disease-free survival.

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Prognostic factors for disease-free and overall survival of patients with uterine carcinosarcoma

Abstract: Lymph node metastasis is the most significant prognostic factor associated with poor DFS and OS in UCS patients.

Cited by 11 publications

References 22 publications

Diagnosis, treatment and survival of uterine sarcoma: A retrospective cohort study of 122 cases

Diagnosis, treatment and survival of uterine sarcoma: A retrospective cohort study of 122 cases

Prognostic significance of lymph node metastasis and lymphadenectomy in early-stage ovarian carcinosarcoma

The prognostic significance of the heterologous component in uterine carcinosarcomas

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