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Effect of treatment of patients with early-stage uterine carcinosarcoma.

Publication ,  Journal Article
Cantrell, LA; Havrilesky, L; O'Malley, D; Liotta, M; Secord, AA; Nagel, C; Fader, AN; Wallace, A; Rose, P; Gehrig, PA
Published in: J Clin Oncol
May 20, 2009

5516 Background: The treatment of early stage uterine carcinosarcoma is controversial. We sought to retrospectively review factors that influence progression and survival. METHODS: A retrospective, multi-institution study of women diagnosed from 1997-2007 was performed. Postoperative treatment included either observation (OBS), RT (brachytherapy, whole pelvic, or combination), chemotherapy (CT) alone or with RT (CT+RT). Data collected included time to recurrence, overall survival, and sites of recurrence. Statistics included ANOVA and Kaplan Meier. RESULTS: One hundred and forty-six patients were diagnosed with early stage (stages 1 and 2) uterine carcinocarcoma. The median age at diagnosis was 68 years (range:40-91). The majority (62%) were Caucasian, 49 (34%) were African-American and the remainder were other ethnicities. One hundred and seventeen had stage 1 disease and 29 had stage 2. The majority of patients (N = 54, 37 %) were observed, 36 (25%) were treated with CT, 31 (21%) were treated with RT and 17 (12%) were treated with CT + RT. The median progression free survival (PFS) for patients diagnosed with early stage disease was 16.7 months for the OBS cohort and 38.2 months for the CT cohort (p < 0.01). Median overall survival was 23 months for the OBS cohort and 39.3 months for the CT cohort (p = 0.02). The cohorts that underwent RT or CT+RT had improved median progression free (29.9, 20 months) and overall survival (31.7, 20.8 months) as compared to the OBS cohort, however this was not a statistically significant difference. CONCLUSIONS: We report on the largest experience in the literature on early stage uterine carcinosarcoma and the first to show that women with early stage disease may benefit from adjuvant chemotherapy. The role of radiation therapy or combination chemotherapy and radiation could not be adequately assessed from this retrospective analysis, but a trend toward improved survival was present. Prospective trials evaluating the best treatment for patients with early stage carcinosarcoma of the uterus should be undertaken to better answer this question. No significant financial relationships to disclose.

Duke Scholars

Published In

J Clin Oncol

EISSN

1527-7755

Publication Date

May 20, 2009

Volume

27

Issue

15_suppl

Start / End Page

5516

Location

United States

Related Subject Headings

  • Oncology & Carcinogenesis
  • 1112 Oncology and Carcinogenesis
  • 1103 Clinical Sciences
 

Citation

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Cantrell, L. A., Havrilesky, L., O’Malley, D., Liotta, M., Secord, A. A., Nagel, C., … Gehrig, P. A. (2009). Effect of treatment of patients with early-stage uterine carcinosarcoma. J Clin Oncol, 27(15_suppl), 5516.
Cantrell, L. A., L. Havrilesky, D. O’Malley, M. Liotta, A. A. Secord, C. Nagel, A. N. Fader, A. Wallace, P. Rose, and P. A. Gehrig. “Effect of treatment of patients with early-stage uterine carcinosarcoma.J Clin Oncol 27, no. 15_suppl (May 20, 2009): 5516.
Cantrell LA, Havrilesky L, O’Malley D, Liotta M, Secord AA, Nagel C, et al. Effect of treatment of patients with early-stage uterine carcinosarcoma. J Clin Oncol. 2009 May 20;27(15_suppl):5516.
Cantrell, L. A., et al. “Effect of treatment of patients with early-stage uterine carcinosarcoma.J Clin Oncol, vol. 27, no. 15_suppl, May 2009, p. 5516.
Cantrell LA, Havrilesky L, O’Malley D, Liotta M, Secord AA, Nagel C, Fader AN, Wallace A, Rose P, Gehrig PA. Effect of treatment of patients with early-stage uterine carcinosarcoma. J Clin Oncol. 2009 May 20;27(15_suppl):5516.

Published In

J Clin Oncol

EISSN

1527-7755

Publication Date

May 20, 2009

Volume

27

Issue

15_suppl

Start / End Page

5516

Location

United States

Related Subject Headings

  • Oncology & Carcinogenesis
  • 1112 Oncology and Carcinogenesis
  • 1103 Clinical Sciences