Management and Prognosis of Patients with Recurrent or Persistent/Progressive Uterine Carcinosarcoma
Uterine carcinosarcoma (UCS) is a highly aggressive gynecologic malignancy. Recurrent or persistent/progressive disease is usually fatal. We aimed to investigate the management and prognosis of these patients. Clinical records of UCS patients from June 1987 to April 2020 were retrospectively reviewe...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-10-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/29/10/601 |
| _version_ | 1797473948536930304 |
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| author | Hsiu-Jung Tung Chi-Yuan Chiang Wei-Yang Chang Ren-Chin Wu Huei-Jean Huang Lan-Yan Yang Chiao-Yun Lin Chun-Chieh Wang Angel Chao Chyong-Huey Lai |
| author_facet | Hsiu-Jung Tung Chi-Yuan Chiang Wei-Yang Chang Ren-Chin Wu Huei-Jean Huang Lan-Yan Yang Chiao-Yun Lin Chun-Chieh Wang Angel Chao Chyong-Huey Lai |
| author_sort | Hsiu-Jung Tung |
| collection | DOAJ |
| description | Uterine carcinosarcoma (UCS) is a highly aggressive gynecologic malignancy. Recurrent or persistent/progressive disease is usually fatal. We aimed to investigate the management and prognosis of these patients. Clinical records of UCS patients from June 1987 to April 2020 were retrospectively reviewed. The stage was re-assigned with the FIGO 2009 staging system. Univariate and multivariate analyses were used to identify the independent predictors of survival after recurrence (SAR) and cancer-specific survival (CSS). Of the 168 patients, 98 experienced treatment failure. The median time to treatment failure (TTF) was 8.1 months (range: 0.0–89.1). The median follow-up time of censored patients was 32.0 months (range: 16.8–170.7). The 5-year SAR rates of those with recurrent or persistent/progressive disease were 7.6%. On multivariate analysis, salvage therapy mainly using radiotherapy (HR 0.27, 95% CI: 0.10–0.71) or chemotherapy (HR 0.41, 95% CI: 0.24–0.72) or chemoradiotherapy (CRT) (HR 0.33, 95% CI: 0.15–0.75) were associated with improved SAR, whereas disseminated recurrence was associated with significantly worse SAR (HR 3.94, 95% CI: 1.67–9.31, <i>p</i> = 0.002). Salvage therapy using radiotherapy or chemotherapy or CRT significantly improved SAR. Surgery significantly improved CSS but not SAR, adjusting for confounding factors. |
| first_indexed | 2024-03-09T20:24:23Z |
| format | Article |
| id | doaj.art-8878e14229294d55a5b3375024261e61 |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-09T20:24:23Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-8878e14229294d55a5b3375024261e612023-11-23T23:40:48ZengMDPI AGCurrent Oncology1198-00521718-77292022-10-0129107607762310.3390/curroncol29100601Management and Prognosis of Patients with Recurrent or Persistent/Progressive Uterine CarcinosarcomaHsiu-Jung Tung0Chi-Yuan Chiang1Wei-Yang Chang2Ren-Chin Wu3Huei-Jean Huang4Lan-Yan Yang5Chiao-Yun Lin6Chun-Chieh Wang7Angel Chao8Chyong-Huey Lai9Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan 333, TaiwanDepartment of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan 333, TaiwanClinical Trial Center, Chang Gung Memorial Hospital, Taoyuan 333, TaiwanGynecologic Cancer Research Center, Chang Gung Memorial Hospital, Taoyuan 333, TaiwanDepartment of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan 333, TaiwanClinical Trial Center, Chang Gung Memorial Hospital, Taoyuan 333, TaiwanGynecologic Cancer Research Center, Chang Gung Memorial Hospital, Taoyuan 333, TaiwanDepartment of Radiation Oncology, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan 333, TaiwanDepartment of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan 333, TaiwanDepartment of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan 333, TaiwanUterine carcinosarcoma (UCS) is a highly aggressive gynecologic malignancy. Recurrent or persistent/progressive disease is usually fatal. We aimed to investigate the management and prognosis of these patients. Clinical records of UCS patients from June 1987 to April 2020 were retrospectively reviewed. The stage was re-assigned with the FIGO 2009 staging system. Univariate and multivariate analyses were used to identify the independent predictors of survival after recurrence (SAR) and cancer-specific survival (CSS). Of the 168 patients, 98 experienced treatment failure. The median time to treatment failure (TTF) was 8.1 months (range: 0.0–89.1). The median follow-up time of censored patients was 32.0 months (range: 16.8–170.7). The 5-year SAR rates of those with recurrent or persistent/progressive disease were 7.6%. On multivariate analysis, salvage therapy mainly using radiotherapy (HR 0.27, 95% CI: 0.10–0.71) or chemotherapy (HR 0.41, 95% CI: 0.24–0.72) or chemoradiotherapy (CRT) (HR 0.33, 95% CI: 0.15–0.75) were associated with improved SAR, whereas disseminated recurrence was associated with significantly worse SAR (HR 3.94, 95% CI: 1.67–9.31, <i>p</i> = 0.002). Salvage therapy using radiotherapy or chemotherapy or CRT significantly improved SAR. Surgery significantly improved CSS but not SAR, adjusting for confounding factors.https://www.mdpi.com/1718-7729/29/10/601carcinosarcomaMMMTendometrial cancersurvival after recurrence |
| spellingShingle | Hsiu-Jung Tung Chi-Yuan Chiang Wei-Yang Chang Ren-Chin Wu Huei-Jean Huang Lan-Yan Yang Chiao-Yun Lin Chun-Chieh Wang Angel Chao Chyong-Huey Lai Management and Prognosis of Patients with Recurrent or Persistent/Progressive Uterine Carcinosarcoma Current Oncology carcinosarcoma MMMT endometrial cancer survival after recurrence |
| title | Management and Prognosis of Patients with Recurrent or Persistent/Progressive Uterine Carcinosarcoma |
| title_full | Management and Prognosis of Patients with Recurrent or Persistent/Progressive Uterine Carcinosarcoma |
| title_fullStr | Management and Prognosis of Patients with Recurrent or Persistent/Progressive Uterine Carcinosarcoma |
| title_full_unstemmed | Management and Prognosis of Patients with Recurrent or Persistent/Progressive Uterine Carcinosarcoma |
| title_short | Management and Prognosis of Patients with Recurrent or Persistent/Progressive Uterine Carcinosarcoma |
| title_sort | management and prognosis of patients with recurrent or persistent progressive uterine carcinosarcoma |
| topic | carcinosarcoma MMMT endometrial cancer survival after recurrence |
| url | https://www.mdpi.com/1718-7729/29/10/601 |
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