Patterns of Failure for Conservatively Managed Surgical Stage I Uterine Carcinosarcoma: Implications for Adjuvant Therapy. Issue 5 (1st July 2009)

• Record Type: Journal Article
• Authors: Leath, Charles A.; Numnum, T. Michael; Kendrick, James E.; Frederick, Peter J.; Rocconi, Rodney P.; Conner, Michael G.; Straughn, J. Michael
• Is Part Of: International journal of gynecological cancer. Volume 19:Issue 5(2009)
• Page Start: 888-891
• Page End: 888-891
• Publication Date: 2009-07-01
• Subjects: Uterine carcinosarcoma -- Mixed mesodermal tumor -- Surgical staging -- Outcomes; Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1111/IGC.0b013e3181a831fb
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : To evaluate patterns of failure and overall survival for patients with surgical stage I uterine carcinosarcoma managed conservatively without adjuvant therapy. A computerized database identified 27 patients whose conditions have been diagnosed with surgical stage I uterine carcinosarcoma from 1993 to 2002. Charts were abstracted for patient demographics, tumor characteristics, recurrence, and survival. Of 27 patients, 23(85%) did not receive adjuvant therapy after undergoing total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic and paraaortic lymphadenectomy. Five patients were stage IA, 14 were stage IB, and 4 were stage IC. Fourteen patients had either poorly differentiated endometrioid carcinoma alone or in combination with papillary serous carcinoma (61%) as their epithelial tumor component. The median nodal count was 9 (range, 3-21). Eleven patients are alive without evidence of disease with a median follow-up of 63 months (range, 12-164 months). Eleven patients had recurrence with a median time to recurrence of 13 months (range, 6-39 months), and all are dead of disease. Univariate analysis demonstrated that poorly differentiated epithelial or papillary serous histologic diagnosis was the only predictor variable associated with recurrence and, consequently, death ( P = 0.04). Approximately 50% of patients with surgical stage I carcinosarcoma who are observed without adjuvant therapy will experience a recurrence. Because most patients will recur distantly, systemic chemotherapy should be considered for patients with early stage uterine carcinosarcoma.