ISSN : 2146-3123
E-ISSN : 2146-3131

Effect of Adjuvant Therapy on Oncologic Outcomes of Surgically Confirmed Stage I Uterine Carcinosarcoma: a Turkish Gynecologic Oncology Study
Günsu Kimyon Cömert1, Osman Türkmen1, Gökhan Boyraz2, İbrahim Yalçın3, Duygu Altın4, Alper Karalök1, Hanifi Şahin3, Salih Taşkın4, Derman Başaran1, Zeliha Fırat Cuylan3, Kazibe Koyuncu4, Mehmet Coşkun Salman2, Nejat Özgül2, Mehmet Mutlu Meydanlı3, Taner Turan1, Fırat Ortaç4, Kunter Yüce2
1Department of Gynecologic Oncology, Ankara Etlik Zübeyde Hanım Women’s Diseases Training and Research Hospital, Ankara, Turkey
2Department of Gynecologic Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
3Department of Gynecologic Oncology, University of Health Sciences, Ankara Zekai Tahir Burak Women’s Health Training and Research Hospital, Ankara, Turkey
4Department of Gynecologic Oncology, Ankara University School of Medicine, Ankara, Turkey
DOI : 10.4274/balkanmedj.galenos.2019.2018.12.75
Pages : 229-234

Abstract

Background: Uterine carcinosarcoma is rare neoplasm that mostly presents as metastatic disease. Stage is one of the most important prognostic factor, however, the management of the early stage uterine carcinosarcoma is still controversial.
Aims: To evaluate prognostic factors, treatment options, and survival outcomes in patients with surgically approved stage I uterine carcinosarcoma.
Study Design: Cross-sectional study.
Methods: Data of 278 patients with uterine carcinosarcoma obtained from four gynecologic oncology centers were reviewed, and 70 patients with approved stage I uterine carcinosarcoma after comprehensive staging surgery were studied.
Results: The median age of the entire cohort was 65 years (range; 39-82). All patients underwent both pelvic and paraaortic lymphadenectomy. Forty-one patients received adjuvant therapy. The median follow-up time was 24 months (range; 1-129). Nineteen (27.1%) patients had disease failure. The 3-year disease-free survival and cancer-specific survival of the entire cohort was 67% and 86%, respectively. In the univariate analysis, only age was significantly associated with disease-free survival (p=0.022). There was no statistical significance for disease-free survival between observation and receiving any type of adjuvant therapy following staging surgery. Advanced age (<75 vs ≥75 years) was the only independent prognostic factor for recurrence (hazard ratio: 3.8, 95% CI=1.10-13.14, p=0.035) in multivariate analysis. None of the factors were significantly associated with cancer-specific survival.
Conclusion: Advanced age was the only independent factor for disease-free survival in stage I uterine carcinosarcoma. Performing any adjuvant therapy following comprehensive lymphadenectomy was not related to the improved survival of the stage I disease.

Keywords : Adjuvant, carcinosarcoma, chemotherapy, radiotherapy, uterine neoplasms
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