Koji Matsuo1, Malcolm S Ross2, Stephen H Bush3, Mayu Yunokawa4, Erin A Blake5, Tadao Takano6, Yutaka Ueda7, Tsukasa Baba8, Shinya Satoh9, Masako Shida10, Yuji Ikeda11, Sosuke Adachi12, Takuhei Yokoyama13, Munetaka Takekuma14, Satoshi Takeuchi15, Masato Nishimura16, Keita Iwasaki17, Shiori Yanai18, Merieme M Klobocista19, Marian S Johnson20, Hiroko Machida21, Kosei Hasegawa22, Takahito M Miyake23, Tadayoshi Nagano24, Tanja Pejovic25, Mian Mk Shahzad3, Dwight D Im26, Kohei Omatsu27, Frederick R Ueland19, Joseph L Kelley2, Lynda D Roman21. 1. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, CA, USA. Electronic address: koji.matsuo@med.usc.edu. 2. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, MaGee-Womens Hospital, University of Pittsburgh, PA, USA. 3. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Moffitt Cancer Center, University of South Florida, FL, USA. 4. Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan. 5. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Colorado, CO, USA. 6. Department of Obstetrics and Gynecology, Tohoku University, Miyagi, Japan. 7. Department of Obstetrics and Gynecology, Osaka University, Osaka, Japan. 8. Department of Obstetrics and Gynecology, Kyoto University, Kyoto, Japan. 9. Department of Obstetrics and Gynecology, Tottori University, Tottori, Japan. 10. Department of Obstetrics and Gynecology, Tokai University, Kanagawa, Japan. 11. Department of Obstetrics and Gynecology, The University of Tokyo, Tokyo, Japan. 12. Department of Obstetrics and Gynecology, Niigata University, Niigata, Japan. 13. Department of Obstetrics and Gynecology, Osaka Rosai Hospital, Osaka, Japan. 14. Department of Obstetrics and Gynecology, Shizuoka Cancer Center, Shizuoka, Japan. 15. Department of Obstetrics and Gynecology, Iwate Medical University, Morioka, Japan. 16. Department of Obstetrics and Gynecology, Tokushima University, Tokushima, Japan. 17. Department of Obstetrics and Gynecology, Aichi Medical University, Aichi, Japan. 18. Department of Obstetrics and Gynecology, Kurashiki Medical Center, Okayama, Japan. 19. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Albert Einstein College of Medicine, Montefiore Medical Center, NY, USA. 20. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky, KY, USA. 21. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, CA, USA. 22. Department of Obstetrics and Gynecology, Saitama Medical University International Medical Center, Saitama, Japan. 23. Department of Obstetrics and Gynecology, Kawasaki Medical School, Okayama, Japan. 24. Department of Obstetrics and Gynecology, Kitano Hospital, Osaka, Japan. 25. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Oregon Health & Science University, OR, USA. 26. The Gynecologic Oncology Center, Mercy Medical Center, Baltimore, MD, USA. 27. Department of Gynecology, Cancer Institute Hospital, Tokyo, Japan.
Abstract
OBJECTIVE: To examine tumor characteristics and survival outcome of women with uterine carcinosarcoma who had a history of tamoxifen use. METHODS: This is a multicenter retrospective study examining stage I-IV uterine carcinosarcoma cases based on history of tamoxifen use. Patient demographics, tumor characteristics, treatment pattern, and survival outcomes were compared between tamoxifen users and non-users. RESULTS: Sixty-six cases of tamoxifen-related uterine carcinosarcoma were compared to 1009 cases with no history of tamoxifen use. Tamoxifen users were more likely to be older (mean age, 69 versus 64, P<0.001) and had a past history of malignancy (100% versus 12.7%, P<0.001). Tamoxifen-related uterine carcinosarcoma was significantly associated with a higher proportion of stage IA disease (48.4% versus 29.9%) and a lower risk of stage IVB disease (7.8% versus 16.0%) compared to tamoxifen-unrelated carcinosarcoma (P=0.034). Deep myometrial tumor invasion was less common in uterine carcinosarcoma related to tamoxifen use (28.3% versus 48.8%, P=0.002). On univariate analysis, tamoxifen use was not associated with progression-free survival (5-year rates 44.5% versus 46.8%, P=0.48) and disease-specific survival (64.0% versus 59.1%, P=0.39). After adjusting for age, past history of malignancy, stage, residual disease status at surgery, and postoperative treatment patterns, tamoxifen use was not associated with progression-free survival (adjusted-hazard ratio 0.86, 95% confidence interval 0.50 to 1.50, P=0.60) and disease-specific survival (adjusted-hazard ratio 0.68, 95% confidence interval 0.36 to 1.29, P=0.24). CONCLUSION: Our study suggests that tamoxifen-related uterine carcinosarcoma may have favorable tumor characteristics but have comparable stage-specific survival outcomes compared to tamoxifen-unrelated uterine carcinosarcoma.
OBJECTIVE: To examine tumor characteristics and survival outcome of women with uterine carcinosarcoma who had a history of tamoxifen use. METHODS: This is a multicenter retrospective study examining stage I-IV uterine carcinosarcoma cases based on history of tamoxifen use. Patient demographics, tumor characteristics, treatment pattern, and survival outcomes were compared between tamoxifen users and non-users. RESULTS: Sixty-six cases of tamoxifen-related uterine carcinosarcoma were compared to 1009 cases with no history of tamoxifen use. Tamoxifen users were more likely to be older (mean age, 69 versus 64, P<0.001) and had a past history of malignancy (100% versus 12.7%, P<0.001). Tamoxifen-related uterine carcinosarcoma was significantly associated with a higher proportion of stage IA disease (48.4% versus 29.9%) and a lower risk of stage IVB disease (7.8% versus 16.0%) compared to tamoxifen-unrelated carcinosarcoma (P=0.034). Deep myometrial tumor invasion was less common in uterine carcinosarcoma related to tamoxifen use (28.3% versus 48.8%, P=0.002). On univariate analysis, tamoxifen use was not associated with progression-free survival (5-year rates 44.5% versus 46.8%, P=0.48) and disease-specific survival (64.0% versus 59.1%, P=0.39). After adjusting for age, past history of malignancy, stage, residual disease status at surgery, and postoperative treatment patterns, tamoxifen use was not associated with progression-free survival (adjusted-hazard ratio 0.86, 95% confidence interval 0.50 to 1.50, P=0.60) and disease-specific survival (adjusted-hazard ratio 0.68, 95% confidence interval 0.36 to 1.29, P=0.24). CONCLUSION: Our study suggests that tamoxifen-related uterine carcinosarcoma may have favorable tumor characteristics but have comparable stage-specific survival outcomes compared to tamoxifen-unrelated uterine carcinosarcoma.
Authors: Koji Matsuo; Kohei Omatsu; Malcolm S Ross; Marian S Johnson; Mayu Yunokawa; Merieme M Klobocista; Dwight D Im; Stephen H Bush; Yutaka Ueda; Tadao Takano; Erin A Blake; Kosei Hasegawa; Tsukasa Baba; Masako Shida; Shinya Satoh; Takuhei Yokoyama; Hiroko Machida; Sosuke Adachi; Yuji Ikeda; Keita Iwasaki; Takahito M Miyake; Shiori Yanai; Masato Nishimura; Tadayoshi Nagano; Munetaka Takekuma; Satoshi Takeuchi; Tanja Pejovic; Mian Mk Shahzad; Frederick R Ueland; Joseph L Kelley; Lynda D Roman Journal: Gynecol Oncol Date: 2017-02-16 Impact factor: 5.482
Authors: Gonzalo Gajardo; Rodrigo López-Muñoz; Anita Plaza; Benjamin Uberti; José Sarmiento; Gabriel Morán; Claudio Henríquez Journal: Ir Vet J Date: 2019-06-20 Impact factor: 2.146