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Clinical significance of radiotherapy in patients with primary uterine carcinosarcoma: a multicenter retrospective study (KROG 13-08)

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Author(s)
Jihye ChaYoung Seok KimWon ParkHak Jae KimJoo-Young KimJin Hee KimJuree KimWon Sup YoonJun Won KimYong Bae Kim1
Keimyung Author(s)
Kim, Jin Hee
Department
Dept. of Radiation Oncology (방사선종양학)
Journal Title
Journal of Gynecologic Oncology
Issued Date
2016
Volume
27
Issue
6
Keyword
Locoregional ControlRadiotherapyAdjuvantUterine Carcinosarcoma
Abstract
Objective: To investigate the role of radiotherapy (RT) in patients who underwent
hysterectomy for uterine carcinosarcoma (UCS).
Methods: Patients with the International Federation of Gynecology and Obstetrics stage I–
IVa UCS who were treated between 1990 and 2012 were identified retrospectively in a multiinstitutional
database. Of 235 identified patients, 97 (41.3%) received adjuvant RT. Twentytwo
patients with a history of previous pelvic RT were analyzed separately. Survival outcomes
were assessed using the Kaplan-Meier method and Cox proportional hazards model.
Results: Patients with a previous history of pelvic RT had poor survival outcomes, and 72.6%
of these patients experienced locoregional recurrence; however, none received RT after a
diagnosis of UCS. Univariate analyses revealed that pelvic lymphadenectomy (PLND) and
para-aortic lymph node sampling were significant factors for locoregional recurrence-free
survival (LRRFS) and disease-free survival (DFS). Among patients without previous pelvic
RT, the percentage of locoregional failure was lower for those who received adjuvant RT than
for those who did not (28.5% vs. 17.5%, p=0.107). Multivariate analysis revealed significant
correlations between PLND and LRRFS, distant metastasis-free survival, and DFS. In
subgroup analyses, RT significantly improved the 5-year LRRFS rate of patients who did not
undergo PLND (52.7% vs. 18.7% for non-RT, p<0.001). Conclusion: Adjuvant RT decreased the risk of locoregional recurrence after hysterectomy for UCS, particularly in patients without surgical nodal staging. Given the poorer locoregional outcomes of patients previously subjected to pelvic RT, meticulous re-administration of RT might improve locoregional control while leading to less toxicity in these patients.
Keimyung Author(s)(Kor)
김진희
Publisher
School of Medicine
Citation
Jihye Cha et al. (2016). Clinical significance of radiotherapy in patients with primary uterine carcinosarcoma: a multicenter retrospective study (KROG 13-08). Journal of Gynecologic Oncology, 27(6), e58–e58. doi: 10.3802/jgo.2016.27.e58
Type
Article
ISSN
2005-0380
DOI
10.3802/jgo.2016.27.e58
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/32454
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학)
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