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Published on: September 12, 2019
Pathologic prognostic factors in stage I-III uterine carcinosarcoma treated with postoperative radiotherapy
Angeles Rovirosa1, Carlos Ascaso, Meritxell Arenas
1Gynecological Cancer Unit, Radiation Oncology Department, Hospital Clinic, ICMHO, IDIBAPS, University of Barcelona, C/Villarroel 170, 08036, Barcelona, Spain, rovirosa@clinic.ub.es.
Purpose:
To analyse the impact of prognostic factors on specific overall survival (SOS) after postoperative radiotherapy (P-RT) in carcinosarcomas.
Methods:
We retrospectively analysed 81 patients who received P-RT from 1977 to 2010 after the diagnosis of carcinosarcomas. 2009 FIGO stage: 25-IA, 20-IB, 6-II, 9-IIIA, 11-IIIC. Age, stage, vascular and lymphatic space invasion (VLSI), myometrial invasion, grade, mitotic index, sarcomatous/epithelial components, tumour size and necrosis were considered for the analysis.
Statistics:
we used the Kaplan-Meier method for survival analysis and the Cox model for risk factor evaluation.
Results:
The mean follow-up of the series was 78.86 months (range 7-381). The median age was 72 years (range 51-89). 30 out 81 (37 %) patients relapsed and died (22.2 % pelvic and abdominal, 13.5 % exclusive distant metastasis). On univariate and multivariate analysis only stage had a significant impact on SOS. At 5 years, stage I-II had a SOS of 66 % in comparison with stage III with 30 %.
Conclusions:
Two groups of patients showing different outcome were found after P-RT in uterine carcinosarcomas: stage I-II patients had a life expectancy 2.5-fold longer compared to stage III patients. New therapeutic strategies are warranted in carcinosarcomas considering the high incidence of distant metastasis.
