Koji Matsuo1, Malcolm S Ross2, Mayu Yunokawa3, Marian S Johnson4, Hiroko Machida5, Kohei Omatsu6, Merieme M Klobocista7, Dwight D Im8, Shinya Satoh9, Tsukasa Baba10, Yuji Ikeda11, Stephen H Bush12, Kosei Hasegawa13, Erin A Blake14, Munetaka Takekuma15, Masako Shida16, Masato Nishimura17, Sosuke Adachi18, Tanja Pejovic19, Satoshi Takeuchi20, Takuhei Yokoyama21, Yutaka Ueda22, Keita Iwasaki23, Takahito M Miyake24, Shiori Yanai25, Tadayoshi Nagano26, Tadao Takano27, Mian Mk Shahzad12, Frederick R Ueland4, Joseph L Kelley2, Lynda D Roman5. 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. Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan. 4. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky, KY, USA. 5. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, CA, USA. 6. Department of Gynecology, Cancer Institute Hospital, Tokyo, Japan. 7. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Albert Einstein College of Medicine, Montefiore Medical Center, NY, USA. 8. The Gynecologic Oncology Center, Mercy Medical Center, Baltimore, MD, USA. 9. Department of Obstetrics and Gynecology, Tottori University, Tottori, Japan. 10. Department of Obstetrics and Gynecology, Kyoto University, Kyoto, Japan. 11. Department of Obstetrics and Gynecology, The University of Tokyo, Tokyo, Japan. 12. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Moffitt Cancer Center, University of South Florida, FL, USA. 13. Department of Obstetrics and Gynecology, Saitama Medical University International Medical Center, Saitama, Japan. 14. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Colorado, CO, USA. 15. Department of Gynecology, Shizuoka Cancer Center, Shizuoka, Japan. 16. Department of Obstetrics and Gynecology, Tokai University, Kanagawa, Japan. 17. Department of Obstetrics and Gynecology, Tokushima University, Tokushima, Japan. 18. Department of Obstetrics and Gynecology, Niigata University, Niigata, Japan. 19. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Oregon Health & Science University, OR, USA. 20. Department of Obstetrics and Gynecology, Iwate Medical University, Morioka, Japan. 21. Department of Obstetrics and Gynecology, Osaka Rosai Hospital, Osaka, Japan. 22. Department of Obstetrics and Gynecology, Osaka University, Osaka, Japan. 23. Department of Obstetrics and Gynecology, Aichi Medical University, Aichi, Japan. 24. Department of Obstetrics and Gynecology, Kawasaki Medical School, Okayama, Japan. 25. Department of Obstetrics and Gynecology, Kurashiki Medical Center, Okayama, Japan. 26. Department of Obstetrics and Gynecology, Kitano Hospital, Osaka, Japan. 27. Department of Obstetrics and Gynecology, Tohoku University, Miyagi, Japan.
Abstract
OBJECTIVE: To examine clinico-pathological characteristics and outcomes of uterine carcinosarcoma (UCS) in women aged ≥80 years. METHODS: This is a secondary analysis of a previous multicenter retrospective study examining 906 women with stage I-IV UCS who underwent primary hysterectomy. Patient demographics, treatment types, tumor characteristics, and survival were examined across aged ≥80 (n = 82 [9.1%]), aged 60-79, (n = 526 [58.1%]), and aged <60 (n = 298 [32.9%]). RESULTS: Women in the aged ≥80 group were more likely to be Caucasian, undergo simple hysterectomy without lymphadenectomy, and receive no postoperative therapy (all, P < 0.05). Tumors in the aged ≥80 group were more likely to have high-grade carcinoma, heterologous sarcoma, and sarcoma dominance but less likely to have lympho-vascular space invasion (all, P < 0.05). Lymphadenectomy did not improve survival in the aged ≥80 group (P > 0.05), whereas lymphadenectomy was protective for survival in the younger groups (both, P < 0.05). Postoperative chemotherapy was associated with improved progression-free survival (PFS) in the aged ≥80 group (hazard ratio [HR] 0.44, 95% confidence interval [CI] 0.22-0.89, P = 0.021). With chemotherapy treatment, women in the aged ≥80 group had PFS similar to those in the aged 60-79 group (HR 0.97, 95%CI 0.51-1.83, P = 0.92). In contrast, without chemotherapy treatment, women in the aged ≥80 group had significantly decreased PFS compared to the aged 60-79 group (HR 1.62, 95%CI 1.09-2.40, P = 0.016). Similar associations were observed for postoperative radiotherapy. CONCLUSION: Nearly 10% of women with UCS are aged ≥80 that are characterized by aggressive tumor factors. Postoperative therapy but not extensive surgery may improve survival in this age group.
OBJECTIVE: To examine clinico-pathological characteristics and outcomes of uterine carcinosarcoma (UCS) in women aged ≥80 years. METHODS: This is a secondary analysis of a previous multicenter retrospective study examining 906 women with stage I-IV UCS who underwent primary hysterectomy. Patient demographics, treatment types, tumor characteristics, and survival were examined across aged ≥80 (n = 82 [9.1%]), aged 60-79, (n = 526 [58.1%]), and aged <60 (n = 298 [32.9%]). RESULTS:Women in the aged ≥80 group were more likely to be Caucasian, undergo simple hysterectomy without lymphadenectomy, and receive no postoperative therapy (all, P < 0.05). Tumors in the aged ≥80 group were more likely to have high-grade carcinoma, heterologous sarcoma, and sarcoma dominance but less likely to have lympho-vascular space invasion (all, P < 0.05). Lymphadenectomy did not improve survival in the aged ≥80 group (P > 0.05), whereas lymphadenectomy was protective for survival in the younger groups (both, P < 0.05). Postoperative chemotherapy was associated with improved progression-free survival (PFS) in the aged ≥80 group (hazard ratio [HR] 0.44, 95% confidence interval [CI] 0.22-0.89, P = 0.021). With chemotherapy treatment, women in the aged ≥80 group had PFS similar to those in the aged 60-79 group (HR 0.97, 95%CI 0.51-1.83, P = 0.92). In contrast, without chemotherapy treatment, women in the aged ≥80 group had significantly decreased PFS compared to the aged 60-79 group (HR 1.62, 95%CI 1.09-2.40, P = 0.016). Similar associations were observed for postoperative radiotherapy. CONCLUSION: Nearly 10% of women with UCS are aged ≥80 that are characterized by aggressive tumor factors. Postoperative therapy but not extensive surgery may improve survival in this age group.
Authors: K Matsuo; Y Takazawa; M S Ross; E Elishaev; I Podzielinski; M Yunokawa; T B Sheridan; S H Bush; M M Klobocista; E A Blake; T Takano; S Matsuzaki; T Baba; S Satoh; M Shida; T Nishikawa; Y Ikeda; S Adachi; T Yokoyama; M Takekuma; K Fujiwara; Y Hazama; D Kadogami; M N Moffitt; S Takeuchi; M Nishimura; K Iwasaki; N Ushioda; M S Johnson; M Yoshida; A Hakam; S W Li; A M Richmond; H Machida; P Mhawech-Fauceglia; Y Ueda; K Yoshino; K Yamaguchi; T Oishi; H Kajiwara; K Hasegawa; M Yasuda; K Kawana; K Suda; T M Miyake; T Moriya; Y Yuba; T Morgan; T Fukagawa; A Wakatsuki; T Sugiyama; T Pejovic; T Nagano; K Shimoya; M Andoh; Y Shiki; T Enomoto; T Sasaki; K Fujiwara; M Mikami; M Shimada; I Konishi; T Kimura; M D Post; M M Shahzad; D D Im; H Yoshida; K Omatsu; F R Ueland; J L Kelley; R G Karabakhtsian; L D Roman Journal: Ann Oncol Date: 2016-04-06 Impact factor: 32.976
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: Andrew D Cherniack; Hui Shen; Vonn Walter; Chip Stewart; Bradley A Murray; Reanne Bowlby; Xin Hu; Shiyun Ling; Robert A Soslow; Russell R Broaddus; Rosemary E Zuna; Gordon Robertson; Peter W Laird; Raju Kucherlapati; Gordon B Mills; John N Weinstein; Jiashan Zhang; Rehan Akbani; Douglas A Levine Journal: Cancer Cell Date: 2017-03-13 Impact factor: 31.743
Authors: J Alejandro Rauh-Hain; Kristen D Starbuck; Larissa A Meyer; Joel Clemmer; John O Schorge; Karen H Lu; Marcela G Del Carmen Journal: Gynecol Oncol Date: 2015-08-22 Impact factor: 5.482
Authors: Koji Matsuo; Malcolm S Ross; Mayu Yunokawa; Marian S Johnson; Hiroko Machida; Kohei Omatsu; Merieme M Klobocista; Dwight D Im; Shinya Satoh; Tsukasa Baba; Yuji Ikeda; Stephen H Bush; Kosei Hasegawa; Erin A Blake; Munetaka Takekuma; Masako Shida; Masato Nishimura; Sosuke Adachi; Tanja Pejovic; Satoshi Takeuchi; Takuhei Yokoyama; Yutaka Ueda; Keita Iwasaki; Takahito M Miyake; Shiori Yanai; Tadayoshi Nagano; Tadao Takano; Mian Mk Shahzad; Frederick R Ueland; Joseph L Kelley; Lynda D Roman Journal: J Gynecol Oncol Date: 2018-11 Impact factor: 4.401