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Erschienen in:
01.08.2014 | Gynecologic Oncology
Pathologic prognostic factors in stage I–III uterine carcinosarcoma treated with postoperative radiotherapy
Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 2/2014
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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.