The Impact of Adjuvant Radiotherapy on Carcinosarcoma of the Uterus

Background.The role of adjuvant radiotherapy in the setting of uterine carcinosarcoma has not been clearly established. Methods.A retrospective review of 60 patients receiving definitive therapy for carcinosarcoma of the uterus was undertaken at a single institution. Twenty-nine of 60 patients were...

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Veröffentlicht in:Gynecologic oncology 1998-01, Vol.68 (1), p.8-13
Hauptverfasser: Gerszten, Kristina, Faul, Clare, Kounelis, Sophia, Huang, Quingshou, Kelley, Joseph, Jones, Mirka W.
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container_end_page 13
container_issue 1
container_start_page 8
container_title Gynecologic oncology
container_volume 68
creator Gerszten, Kristina
Faul, Clare
Kounelis, Sophia
Huang, Quingshou
Kelley, Joseph
Jones, Mirka W.
description Background.The role of adjuvant radiotherapy in the setting of uterine carcinosarcoma has not been clearly established. Methods.A retrospective review of 60 patients receiving definitive therapy for carcinosarcoma of the uterus was undertaken at a single institution. Twenty-nine of 60 patients were treated with adjuvant radiotherapy. Results.The addition of radiotherapy significantly reduced the local recurrence rate from 55% (17 patients) to 3% (1 patient). Adjuvant radiotherapy reduced the risk of distant failure and death in patients with disease confined to the uterus but did not impact distant recurrence or survival in stage III patients. Increasing stage and depth of myometrial tumor invasion were negatively associated with overall survival and disease-free survival but had no impact on local recurrence rates. The nuclear grade of the epithelial component was predictive of local recurrence (P= 0.0592), but epithelial architectural grade, grade of stromal component, and stromal versus epithelial predominance did not provide prognostic information. The relative risk of local recurrence of unirradiated patients versus irradiated patients was 17.54 (P= 0.0055) after adjusting for nuclear grade of the epithelial component. Conclusions.Local failure represents a significant site of failure in the absence of adjuvant radiotherapy. The improvement in local failure rates with the addition of radiotherapy translates into an improvement in distant failure rates and survival only for patients with stage I/II disease. Epithelial nuclear grade, in addition to depth of myometrial invasion and stage, provides important prognostic information. Epithelial architectural grade, stromal grade, type of stromal component (homologous versus heterologous), and predominance of either stromal or epithelial component were not found to be significant prognostic factors.
doi_str_mv 10.1006/gyno.1997.4901
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Methods.A retrospective review of 60 patients receiving definitive therapy for carcinosarcoma of the uterus was undertaken at a single institution. Twenty-nine of 60 patients were treated with adjuvant radiotherapy. Results.The addition of radiotherapy significantly reduced the local recurrence rate from 55% (17 patients) to 3% (1 patient). Adjuvant radiotherapy reduced the risk of distant failure and death in patients with disease confined to the uterus but did not impact distant recurrence or survival in stage III patients. Increasing stage and depth of myometrial tumor invasion were negatively associated with overall survival and disease-free survival but had no impact on local recurrence rates. The nuclear grade of the epithelial component was predictive of local recurrence (P= 0.0592), but epithelial architectural grade, grade of stromal component, and stromal versus epithelial predominance did not provide prognostic information. The relative risk of local recurrence of unirradiated patients versus irradiated patients was 17.54 (P= 0.0055) after adjusting for nuclear grade of the epithelial component. Conclusions.Local failure represents a significant site of failure in the absence of adjuvant radiotherapy. The improvement in local failure rates with the addition of radiotherapy translates into an improvement in distant failure rates and survival only for patients with stage I/II disease. Epithelial nuclear grade, in addition to depth of myometrial invasion and stage, provides important prognostic information. Epithelial architectural grade, stromal grade, type of stromal component (homologous versus heterologous), and predominance of either stromal or epithelial component were not found to be significant prognostic factors.</description><identifier>ISSN: 0090-8258</identifier><identifier>EISSN: 1095-6859</identifier><identifier>DOI: 10.1006/gyno.1997.4901</identifier><identifier>PMID: 9454652</identifier><identifier>CODEN: GYNOA3</identifier><language>eng</language><publisher>San Diego, CA: Elsevier Inc</publisher><subject>adjuvant radiotherapy ; Aged ; Biological and medical sciences ; Carcinosarcoma - pathology ; Carcinosarcoma - radiotherapy ; Carcinosarcoma - surgery ; distant relapse ; Epithelium - pathology ; Female ; Genital system. Mammary gland ; Humans ; Hysterectomy - standards ; local relapse ; Lymph Node Excision ; Medical sciences ; Neoplasm Staging ; Prognosis ; prognostic factors ; Radiotherapy, Adjuvant - standards ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Retrospective Studies ; uterine carcinosarcoma ; Uterine Neoplasms - pathology ; Uterine Neoplasms - radiotherapy ; Uterine Neoplasms - surgery</subject><ispartof>Gynecologic oncology, 1998-01, Vol.68 (1), p.8-13</ispartof><rights>1998 Academic Press</rights><rights>1998 INIST-CNRS</rights><rights>Copyright 1998 Academic Press.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c436t-801ed030771969786cb0025233f2df612ec1cbb9073157d09fe2a557395ade723</citedby><cites>FETCH-LOGICAL-c436t-801ed030771969786cb0025233f2df612ec1cbb9073157d09fe2a557395ade723</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0090825897949015$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>309,310,314,776,780,785,786,3537,4036,4037,23909,23910,25118,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=2152642$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9454652$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gerszten, Kristina</creatorcontrib><creatorcontrib>Faul, Clare</creatorcontrib><creatorcontrib>Kounelis, Sophia</creatorcontrib><creatorcontrib>Huang, Quingshou</creatorcontrib><creatorcontrib>Kelley, Joseph</creatorcontrib><creatorcontrib>Jones, Mirka W.</creatorcontrib><title>The Impact of Adjuvant Radiotherapy on Carcinosarcoma of the Uterus</title><title>Gynecologic oncology</title><addtitle>Gynecol Oncol</addtitle><description>Background.The role of adjuvant radiotherapy in the setting of uterine carcinosarcoma has not been clearly established. Methods.A retrospective review of 60 patients receiving definitive therapy for carcinosarcoma of the uterus was undertaken at a single institution. Twenty-nine of 60 patients were treated with adjuvant radiotherapy. Results.The addition of radiotherapy significantly reduced the local recurrence rate from 55% (17 patients) to 3% (1 patient). Adjuvant radiotherapy reduced the risk of distant failure and death in patients with disease confined to the uterus but did not impact distant recurrence or survival in stage III patients. Increasing stage and depth of myometrial tumor invasion were negatively associated with overall survival and disease-free survival but had no impact on local recurrence rates. The nuclear grade of the epithelial component was predictive of local recurrence (P= 0.0592), but epithelial architectural grade, grade of stromal component, and stromal versus epithelial predominance did not provide prognostic information. The relative risk of local recurrence of unirradiated patients versus irradiated patients was 17.54 (P= 0.0055) after adjusting for nuclear grade of the epithelial component. Conclusions.Local failure represents a significant site of failure in the absence of adjuvant radiotherapy. The improvement in local failure rates with the addition of radiotherapy translates into an improvement in distant failure rates and survival only for patients with stage I/II disease. Epithelial nuclear grade, in addition to depth of myometrial invasion and stage, provides important prognostic information. Epithelial architectural grade, stromal grade, type of stromal component (homologous versus heterologous), and predominance of either stromal or epithelial component were not found to be significant prognostic factors.</description><subject>adjuvant radiotherapy</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Carcinosarcoma - pathology</subject><subject>Carcinosarcoma - radiotherapy</subject><subject>Carcinosarcoma - surgery</subject><subject>distant relapse</subject><subject>Epithelium - pathology</subject><subject>Female</subject><subject>Genital system. Mammary gland</subject><subject>Humans</subject><subject>Hysterectomy - standards</subject><subject>local relapse</subject><subject>Lymph Node Excision</subject><subject>Medical sciences</subject><subject>Neoplasm Staging</subject><subject>Prognosis</subject><subject>prognostic factors</subject><subject>Radiotherapy, Adjuvant - standards</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. 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Mammary gland</topic><topic>Humans</topic><topic>Hysterectomy - standards</topic><topic>local relapse</topic><topic>Lymph Node Excision</topic><topic>Medical sciences</topic><topic>Neoplasm Staging</topic><topic>Prognosis</topic><topic>prognostic factors</topic><topic>Radiotherapy, Adjuvant - standards</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Retrospective Studies</topic><topic>uterine carcinosarcoma</topic><topic>Uterine Neoplasms - pathology</topic><topic>Uterine Neoplasms - radiotherapy</topic><topic>Uterine Neoplasms - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gerszten, Kristina</creatorcontrib><creatorcontrib>Faul, Clare</creatorcontrib><creatorcontrib>Kounelis, Sophia</creatorcontrib><creatorcontrib>Huang, Quingshou</creatorcontrib><creatorcontrib>Kelley, Joseph</creatorcontrib><creatorcontrib>Jones, Mirka W.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Gynecologic oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gerszten, Kristina</au><au>Faul, Clare</au><au>Kounelis, Sophia</au><au>Huang, Quingshou</au><au>Kelley, Joseph</au><au>Jones, Mirka W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Impact of Adjuvant Radiotherapy on Carcinosarcoma of the Uterus</atitle><jtitle>Gynecologic oncology</jtitle><addtitle>Gynecol Oncol</addtitle><date>1998-01</date><risdate>1998</risdate><volume>68</volume><issue>1</issue><spage>8</spage><epage>13</epage><pages>8-13</pages><issn>0090-8258</issn><eissn>1095-6859</eissn><coden>GYNOA3</coden><abstract>Background.The role of adjuvant radiotherapy in the setting of uterine carcinosarcoma has not been clearly established. 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The relative risk of local recurrence of unirradiated patients versus irradiated patients was 17.54 (P= 0.0055) after adjusting for nuclear grade of the epithelial component. Conclusions.Local failure represents a significant site of failure in the absence of adjuvant radiotherapy. The improvement in local failure rates with the addition of radiotherapy translates into an improvement in distant failure rates and survival only for patients with stage I/II disease. Epithelial nuclear grade, in addition to depth of myometrial invasion and stage, provides important prognostic information. Epithelial architectural grade, stromal grade, type of stromal component (homologous versus heterologous), and predominance of either stromal or epithelial component were not found to be significant prognostic factors.</abstract><cop>San Diego, CA</cop><pub>Elsevier Inc</pub><pmid>9454652</pmid><doi>10.1006/gyno.1997.4901</doi><tpages>6</tpages></addata></record>
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ispartof Gynecologic oncology, 1998-01, Vol.68 (1), p.8-13
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subjects adjuvant radiotherapy
Aged
Biological and medical sciences
Carcinosarcoma - pathology
Carcinosarcoma - radiotherapy
Carcinosarcoma - surgery
distant relapse
Epithelium - pathology
Female
Genital system. Mammary gland
Humans
Hysterectomy - standards
local relapse
Lymph Node Excision
Medical sciences
Neoplasm Staging
Prognosis
prognostic factors
Radiotherapy, Adjuvant - standards
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Retrospective Studies
uterine carcinosarcoma
Uterine Neoplasms - pathology
Uterine Neoplasms - radiotherapy
Uterine Neoplasms - surgery
title The Impact of Adjuvant Radiotherapy on Carcinosarcoma of the Uterus
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