Marco A C Versluis1, Cindy Pielsticker1, Maaike A van der Aa2, Marco de Bruyn1, Harry Hollema3, Hans W Nijman1. 1. Department of Obstetrics and Gynecology, University Medical Center Groningen, Groningen, the Netherlands. 2. Netherlands Comprehensive Cancer Organisation (IKNL), Groningen, the Netherlands. 3. Division of Pathology, Department of Pathology and Medical Biology, University Medical Center Groningen, Groningen, the Netherlands.
Abstract
OBJECTIVE: Uterine carcinosarcoma is a rare, aggressive subtype of endometrial cancer. Treatment consists of hysterectomy, bilateral salpingo-oophorectomy, and lymphadenectomy (LND). The survival benefit of LND in relation to adjuvant radio- and/or chemotherapy is unclear. We evaluated the impact of LND on survival in relation to adjuvant therapy in uterine carcinosarcoma. METHODS: Retrospective data on 1,140 cases were combined from the Netherlands Cancer Registry (NCR) and the nationwide network and registry of histo- and cytopathology in the Netherlands (PALGA). LND was defined as the removal of any nodes. Additionally, cases where 10 nodes or less (LND ≤10) or more than 10 nodes (LND > 10) were removed were analyzed separately. Adjuvant therapy was evaluated as radiotherapy, chemotherapy, or radiochemotherapy. Associations were analyzed by χ2 test, log-rank test, and Cox regression analysis. RESULTS: Overall survival (OS) had improved after total abdominal hysterectomy with bilateral salpingo-oophorectomy with LND > 10 (HR 0.62, 95% CI 0.47-0.83). Adjuvant therapy was related to OS with an HR of 0.64 (95% CI 0.54-0.75) for radiotherapy, an HR of 0.65 (95% CI 0.48-0.88) for chemotherapy, and an HR of 0.25 (95% CI 0.13-0.46) for radiochemotherapy. Additionally, adjuvant treatment was related to OS when lymph nodes were positive (HR 0.22, 95% CI 0.11-0.42), but not when they were negative. CONCLUSION: LND is related to improved survival when more than 10 nodes are removed. Adjuvant therapy improves survival when LND is omitted, or when nodes are positive.
OBJECTIVE: Uterine carcinosarcoma is a rare, aggressive subtype of endometrial cancer. Treatment consists of hysterectomy, bilateral salpingo-oophorectomy, and lymphadenectomy (LND). The survival benefit of LND in relation to adjuvant radio- and/or chemotherapy is unclear. We evaluated the impact of LND on survival in relation to adjuvant therapy in uterine carcinosarcoma. METHODS: Retrospective data on 1,140 cases were combined from the Netherlands Cancer Registry (NCR) and the nationwide network and registry of histo- and cytopathology in the Netherlands (PALGA). LND was defined as the removal of any nodes. Additionally, cases where 10 nodes or less (LND ≤10) or more than 10 nodes (LND > 10) were removed were analyzed separately. Adjuvant therapy was evaluated as radiotherapy, chemotherapy, or radiochemotherapy. Associations were analyzed by χ2 test, log-rank test, and Cox regression analysis. RESULTS: Overall survival (OS) had improved after total abdominal hysterectomy with bilateral salpingo-oophorectomy with LND > 10 (HR 0.62, 95% CI 0.47-0.83). Adjuvant therapy was related to OS with an HR of 0.64 (95% CI 0.54-0.75) for radiotherapy, an HR of 0.65 (95% CI 0.48-0.88) for chemotherapy, and an HR of 0.25 (95% CI 0.13-0.46) for radiochemotherapy. Additionally, adjuvant treatment was related to OS when lymph nodes were positive (HR 0.22, 95% CI 0.11-0.42), but not when they were negative. CONCLUSION: LND is related to improved survival when more than 10 nodes are removed. Adjuvant therapy improves survival when LND is omitted, or when nodes are positive.
Authors: K Kokawa; K Nishiyama; M Ikeuchi; Y Ihara; N Akamatsu; T Enomoto; O Ishiko; S Motoyama; S Fujii; N Umesaki Journal: Int J Gynecol Cancer Date: 2006 May-Jun Impact factor: 3.437
Authors: Joseph Menczer; Tally Levy; Benjamin Piura; Angela Chetrit; Marco Altaras; Mihai Meirovitz; Marek Glezerman; Ami Fishman Journal: Gynecol Oncol Date: 2005-04 Impact factor: 5.482
Authors: Frederic Amant; Isabelle Cadron; Luca Fuso; Patrick Berteloot; Eric de Jonge; Gerd Jacomen; Johan Van Robaeys; Patrick Neven; Philippe Moerman; Ignace Vergote Journal: Gynecol Oncol Date: 2005-08 Impact factor: 5.482
Authors: Aaron H Wolfson; Mark F Brady; Thomas Rocereto; Robert S Mannel; Yi-Chun Lee; Robert J Futoran; David E Cohn; Olga B Ioffe Journal: Gynecol Oncol Date: 2007-09-05 Impact factor: 5.482
Authors: Jason D Wright; Venkatraman E Seshan; Monjri Shah; Peter B Schiff; William M Burke; Carmel J Cohen; Thomas J Herzog Journal: Am J Obstet Gynecol Date: 2008-06-03 Impact factor: 8.661
Authors: M Casparie; A T M G Tiebosch; G Burger; H Blauwgeers; A van de Pol; J H J M van Krieken; G A Meijer Journal: Cell Oncol Date: 2007 Impact factor: 6.730
Authors: Mac Versluis; A Plat; M de Bruyn; X Matias-Guiu; J Trovic; C Krakstad; H W Nijman; T Bosse; G H de Bock; H Hollema Journal: Virchows Arch Date: 2018-08-23 Impact factor: 4.064
Authors: Giacomo Corrado; Francesca Ciccarone; Francesco Cosentino; Francesco Legge; Andrea Rosati; Martina Arcieri; Luigi Carlo Turco; Camilla Certelli; Alex Federico; Enrico Vizza; Francesco Fanfani; Giovanni Scambia; Gabriella Ferrandina Journal: J Cancer Res Clin Oncol Date: 2020-09-03 Impact factor: 4.553
Authors: Kerri Beckmann; Sudarshan Selva-Nayagam; Ian Olver; Caroline Miller; Elizabeth S Buckley; Kate Powell; Dianne Buranyi-Trevarton; Raghu Gowda; David Roder; Martin K Oehler Journal: Cancer Manag Res Date: 2021-06-10 Impact factor: 3.989