Outcome and Predictive Factors in Uterine Carcinosarcoma Using Postoperative Radiotherapy: A Rare Cancer Network Study.

Zwahlen, Daniel R; Schick, Ulrike; Bolukbasi, Yasemin; Thariat, Juliette; Abdah-Bortnyak, Roxolyana; Kuten, Abraham; Igdem, Sefik; Caglar, Hale; Ozsaran, Zeynep; Lössl, Kristina; Belkaaloul, Kaouthar Khanfir; Villette, Sylviane; Vees, Hansjörg (2016). Outcome and Predictive Factors in Uterine Carcinosarcoma Using Postoperative Radiotherapy: A Rare Cancer Network Study. Rare tumors, 8(2), p. 6052. PAGEPress 10.4081/rt.2016.6052

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Uterine carcinosarcomas (UCS) are rare tumors. Consensus regarding therapeutic management in non-metastatic disease is lacking. This study reports on outcome and predictive factors when using postoperative radiotherapy. We analyzed a retrospective analysis in 124 women treated between 1987-2007 in the framework of the Rare-Cancer-Network. Median follow-up was 27 months. Postoperative pelvic EBRT was administered in 105 women (85%) and 92 patients (74%) received exclusive or additional vaginal brachytherapy. Five-year overall survival (OS), disease-free survival (DFS), cancer specific survival (CSS) and locoregional control (LRC) were 51.6% (95% CI 35-73%), 53.7% (39-71%), 58.6% (38-74%) and 48% (38-67%). Multivariate analysis showed that external beam radiation therapy (EBRT) >50Gy was an independent prognostic factor for better OS (P=0.03), CSS (P=0.02) and LRC (P=0.01). Relative risks (RR) for better OS (P=0.02), DFS (P=0.04) and LRC (P=0.01) were significantly associated with younger age (≤60 years). Higher brachytherapy (BT)-dose (>9Gy) improved DFS (P=0.04) and LRC (P=0.008). We concluded that UCS has high systemic failure rate. Local relapse was reduced by a relative risk factor of over three in all stages of diseases when using higher doses for EBRT and brachytherapy. Postoperative RT was most effective in UCS stage I/II-diseases.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Radiation Oncology

UniBE Contributor:

Lössl, Kristina

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2036-3605

Publisher:

PAGEPress

Language:

English

Submitter:

Beatrice Scheidegger

Date Deposited:

16 Mar 2017 11:21

Last Modified:

17 Mar 2017 11:53

Publisher DOI:

10.4081/rt.2016.6052

PubMed ID:

27441069

Uncontrolled Keywords:

Carcinosarcoma; brachytherapy; radiotherapy; toxicity; uterine malignancies

BORIS DOI:

10.7892/boris.92751

URI:

https://boris.unibe.ch/id/eprint/92751

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