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Prognostic factors impacting survival in early stage uterine carcinosarcoma.

Publication ,  Journal Article
Kurnit, KC; Previs, RA; Soliman, PT; Westin, SN; Klopp, AH; Fellman, BM; Lu, KH; Ramondetta, LM; Fleming, ND
Published in: Gynecol Oncol
January 2019

OBJECTIVE: Evaluate the impact of clinicopathologic characteristics and adjuvant treatment on survival outcomes in early stage uterine carcinosarcoma patients. METHODS: We performed a retrospective cohort study of women with stage I or II uterine carcinosarcoma at our institution between March 1990 and June 2016. All pathology had been reviewed and confirmed by gynecologic pathologists. Data were extracted from the electronic medical record. Descriptive and comparative statistics were used to compare clinicopathologic characteristics. Univariable and multivariable analyses were performed for survival outcomes. RESULTS: 140 patients were identified. Median age was 67 years (range: 36-91). Median follow-up was 39.1 months (2.9-297.4). The majority of patients had stage IA (67%) versus stage IB (21%) or stage II (11%) disease. The majority of patients (63%) received adjuvant treatment: vaginal brachytherapy only (14%); whole pelvic radiation therapy only (16%); chemotherapy only (n = 13, 9%); combination chemotherapy and vaginal brachytherapy (15%); combination chemotherapy and whole pelvic radiation (9%). 52 patients (37%) received no adjuvant therapy. Median overall survival (OS) was 48.0 months (95% CI 32.7-80.9). On multivariable analysis for OS, advancing age (HR 1.05, 95% CI 1.03-1.08, p < 0.001), higher stage (stage IB: HR 1.64, 95% CI 0.91-2.95, p = 0.10; stage II: HR 3.04, 95% CI 1.51-6.13, p = 0.002), and the presence of a rhabdomyosarcoma component (HR 1.66, 95% CI 1.02-2.70, p = 0.04) were significantly associated with worse OS. CONCLUSIONS: Advancing age, stage, and the presence of a rhabdomyosarcoma component were all associated with worse OS in patients with early stage uterine carcinosarcoma. New treatment algorithms should incorporate factors aside from stage alone.

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Published In

Gynecol Oncol

DOI

EISSN

1095-6859

Publication Date

January 2019

Volume

152

Issue

1

Start / End Page

31 / 37

Location

United States

Related Subject Headings

  • Uterine Neoplasms
  • Retrospective Studies
  • Prognosis
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Middle Aged
  • Humans
  • Female
  • Carcinosarcoma
  • Aged, 80 and over
 

Citation

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Kurnit, K. C., Previs, R. A., Soliman, P. T., Westin, S. N., Klopp, A. H., Fellman, B. M., … Fleming, N. D. (2019). Prognostic factors impacting survival in early stage uterine carcinosarcoma. Gynecol Oncol, 152(1), 31–37. https://doi.org/10.1016/j.ygyno.2018.10.034
Kurnit, Katherine C., Rebecca A. Previs, Pamela T. Soliman, Shannon N. Westin, Ann H. Klopp, Bryan M. Fellman, Karen H. Lu, Lois M. Ramondetta, and Nicole D. Fleming. “Prognostic factors impacting survival in early stage uterine carcinosarcoma.Gynecol Oncol 152, no. 1 (January 2019): 31–37. https://doi.org/10.1016/j.ygyno.2018.10.034.
Kurnit KC, Previs RA, Soliman PT, Westin SN, Klopp AH, Fellman BM, et al. Prognostic factors impacting survival in early stage uterine carcinosarcoma. Gynecol Oncol. 2019 Jan;152(1):31–7.
Kurnit, Katherine C., et al. “Prognostic factors impacting survival in early stage uterine carcinosarcoma.Gynecol Oncol, vol. 152, no. 1, Jan. 2019, pp. 31–37. Pubmed, doi:10.1016/j.ygyno.2018.10.034.
Kurnit KC, Previs RA, Soliman PT, Westin SN, Klopp AH, Fellman BM, Lu KH, Ramondetta LM, Fleming ND. Prognostic factors impacting survival in early stage uterine carcinosarcoma. Gynecol Oncol. 2019 Jan;152(1):31–37.
Journal cover image

Published In

Gynecol Oncol

DOI

EISSN

1095-6859

Publication Date

January 2019

Volume

152

Issue

1

Start / End Page

31 / 37

Location

United States

Related Subject Headings

  • Uterine Neoplasms
  • Retrospective Studies
  • Prognosis
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Middle Aged
  • Humans
  • Female
  • Carcinosarcoma
  • Aged, 80 and over