Survival of patients with uterine carcinosarcoma undergoing sentinel lymph node mapping Journal Article


Authors: Schiavone, M. B.; Zivanovic, O.; Zhou, Q.; Leitao, M. M. Jr; Levine, D. A.; Soslow, R. A.; Alektiar, K. M.; Makker, V.; Iasonos, A.; Abu-Rustum, N. R.
Article Title: Survival of patients with uterine carcinosarcoma undergoing sentinel lymph node mapping
Abstract: Purpose: This study was designed to evaluate the outcome of patients with uterine carcinosarcoma undergoing sentinel lymph node (SLN) mapping. Methods: A prospectively maintained database was reviewed for all women with uterine cancer treated at our institution from January 1, 1998 to August 31, 2014. Patients were grouped based on whether they had undergone SLN mapping or routine lymphadenectomy at the time of staging. SLN evaluation was performed according to a standard institutional protocol that incorporates a surgical algorithm and pathologic ultrastaging. Results: We identified 136 patients with uterine carcinosarcoma who had undergone lymph node evaluation; 48 had surgical staging with SLN mapping and 88 had routine lymphadenectomy consisting of pelvic and/or para-aortic lymph node dissection. Stage distribution for the SLN group included: stage I, 31 (65 %); stage II, 1 (2 %); stage III, 11 (23 %); stage IV, 5 (10 %). Stage distribution for the non-SLN group included: stage I, 48 (55 %); stage II, 4 (4 %); stage III, 19 (22 %); stage IV, 17 (19 %) (p = 0.4). Median number of lymph nodes removed was 8 and 20, respectively (p ≤ 0.001). Median number of positive nodes was similar between the groups (p = 0.2). Of the 67 patients who had a documented recurrence, 14 of 20 (70 %) in the SLN and 34 of 47 (74 %) in the non-SLN group demonstrated a distant/multifocal pattern of recurrence. There was no difference in median progression-free survival between the groups (23 vs. 23.2 months, respectively; p = 0.7). Conclusions: Progression-free survival in women with uterine carcinosarcoma undergoing SLN mapping with adjuvant therapy appears similar to that of patients treated before the incorporation of the SLN protocol. Additional prospective studies with longer follow-up are necessary to validate these early results. © 2015, Society of Surgical Oncology.
Keywords: adult; cancer survival; controlled study; aged; cancer surgery; major clinical study; cancer combination chemotherapy; multimodality cancer therapy; paclitaxel; adjuvant therapy; cancer radiotherapy; cancer staging; follow up; lymph node dissection; sentinel lymph node mapping; prospective study; carboplatin; progression free survival; external beam radiotherapy; uterus carcinoma; carcinosarcoma; uterine carcinosarcoma; intravaginal radiation therapy; very elderly; human; female; article
Journal Title: Annals of Surgical Oncology
Volume: 23
Issue: 1
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2016-01-01
Start Page: 196
End Page: 202
Language: English
DOI: 10.1245/s10434-015-4612-2
PROVIDER: scopus
PUBMED: 25994210
PMCID: PMC4836610
DOI/URL:
Notes: Article -- Export Date: 3 February 2016 -- Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Vicky Makker
    263 Makker
  2. Kaled M Alektiar
    333 Alektiar
  3. Douglas A Levine
    380 Levine
  4. Mario Leitao
    575 Leitao
  5. Oliver Zivanovic
    291 Zivanovic
  6. Qin Zhou
    253 Zhou
  7. Alexia Elia Iasonos
    362 Iasonos
  8. Robert Soslow
    793 Soslow