A multi-institutional cohort study of adjuvant therapy in stage I-II uterine carcinosarcoma

作者：Cantrell Leigh A^*; Havrilesky Laura; Moore Dominic T; O' Malley David; Liotta Margaret; Secord Angeles Alvarez; Nagel Christa I; Cohn David E; Fader Amanda Nickles; Wallace Amy H; Rose Peter; Gehrig Paola A

来源：Gynecologic Oncology, 2012, 127(1): 22-26.

DOI：10.1016/j.ygyno.2012.06.020

• Carcinosarcoma
• MMMT
• Early-stage
• Therapy

Objective. To evaluate the impact of adjuvant post-operative therapy in women with early stage uterine carcinosarcoma. %26lt;br%26gt;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). %26lt;br%26gt;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%26lt;0.0001) and a pre-existing cancer (p = 0.004) were most predictive of PFS. LVSI was predictive of shortened OS (p = 0.01). %26lt;br%26gt;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.

• 出版日期2012-10