The role of cytoreductive surgery for newly diagnosed advanced-stage uterine carcinosarcoma Journal Article

Authors: Tanner, E. J.; Leitao, M. M. Jr; Garg, K.; Chi, D. S.; Sonoda, Y.; Gardner, G. J.; Barakat, R. R.; Jewell, E. L.
Article Title: The role of cytoreductive surgery for newly diagnosed advanced-stage uterine carcinosarcoma
Abstract: Objectives: Uterine carcinosarcoma (CS) is a rare but aggressive malignancy frequently associated with extrauterine metastasis at the time of diagnosis. The objective of this study was to assess the role of cytoreductive surgery in patients with stage IIIC-IVB uterine CS. Methods: We conducted a retrospective review of all patients with uterine CS treated at our institution from 1990 to 2009. Clinicopathologic factors, surgical procedures, adjuvant therapy, and survival outcomes were collected for all patients. Progression-free survival (PFS) and overall survival (OS) were calculated using the Kaplan-Meier method. Factors predictive of survival outcomes were compared using the log-rank test and Cox regression analysis. Results: An analysis of 44 patients was performed (stage IIIC, n = 14; stage IVB, n = 30). Complete gross resection was achieved in 57% of patients. PFS and OS for the entire cohort were 8.6 months and 18.5 months, respectively. Complete gross resection was associated with a median OS of 52.3 months versus 8.6 months in patients with gross residual disease (P < 0.0001). Stage IIIC disease was associated with a median OS of 52.3 months versus 17.5 months for patients with stage IVB disease. In patients who received adjuvant therapy, OS was 30.1 months versus 4.7 months in patients who did not receive adjuvant therapy (P < 0.001). On multivariate analysis, only complete gross resection and the ability to receive adjuvant therapy were independently associated with OS. Conclusions: Cytoreductive surgery, with a goal of achieving a complete gross resection, is associated with an improvement in OS among patients with advanced uterine CS. © 2011 Published by Elsevier Inc.
Keywords: adult; cancer survival; aged; aged, 80 and over; disease-free survival; middle aged; retrospective studies; major clinical study; overall survival; disease course; advanced cancer; paclitaxel; adjuvant therapy; cancer adjuvant therapy; chemotherapy, adjuvant; radiotherapy, adjuvant; cancer staging; outcome assessment; follow up; hysterectomy; endometrial neoplasms; neoplasm staging; cytoreductive surgery; carboplatin; progression free survival; cohort studies; ovariectomy; retrospective study; postoperative complication; neoplasm, residual; neoplasm metastasis; surgery; cytoreduction; uterus sarcoma; chemoradiotherapy; carcinosarcoma; salpingectomy; uterine carcinosarcoma; uterus carcinosarcoma
Journal Title: Gynecologic Oncology
Volume: 123
Issue: 3
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2011-12-01
Start Page: 548
End Page: 552
Language: English
DOI: 10.1016/j.ygyno.2011.08.020
PROVIDER: scopus
PUBMED: 21945551
Notes: --- - "Export Date: 9 December 2011" - "CODEN: GYNOA" - "Source: Scopus"
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MSK Authors
  1. Ginger J Gardner
    146 Gardner
  2. Elizabeth Jewell
    57 Jewell
  3. Richard R Barakat
    627 Barakat
  4. Dennis S Chi
    511 Chi
  5. Yukio Sonoda
    298 Sonoda
  6. Mario Leitao
    329 Leitao
  7. Edward James Tanner
    40 Tanner
  8. Karuna Garg
    76 Garg