Radiat Oncol J.  2011 Dec;29(4):228-235. 10.3857/roj.2011.29.4.228.

The influence of adjuvant radiotherapy on patterns of failure and survivals in uterine carcinosarcoma

• Park HJ
• Kim HJ
• Wu HG
• Kim H
• Ha SW
• Kang SB
• Song YS
• Park NH
• Kim JW

• KMID: 1842019
• DOI: http://doi.org/10.3857/roj.2011.29.4.228

Abstract

PURPOSE
To evaluate the impact of postoperative radiotherapy (PORT) on patterns of failure and survivals in uterine carcinosarcoma patients treated with radical surgery.
MATERIALS AND METHODS
Between October 1998 and August 2010, 19 patients with stage I-III uterine carcinosarcoma received curative hysterectomy and bilateral salpingo-oophorectomy with or without PORT at Seoul National University Hospital. Their hospital medical records were retrospectively reviewed. PORT and non-PORT groups included 11 and 8 patients, respectively. They were followed for a mean of 22.7 months (range, 7.8 to 126.6 months).
RESULTS
At 5 years, the overall survival rates were 51.9% for entire, 61.4% for PORT, and 41.7% for non-PORT groups, respectively. There was no statistical difference between PORT and non-PORT groups with regard to overall survival (p = 0.682). Seven out of 19 (36.8%) patients showed treatment failures, which all happened within 12 months. Although the predominant failures were distant metastasis in PORT group and loco-regional recurrence in non-PORT group, there was no statistically significant difference in loco-regional recurrence-free survival (LRRFS) (p = 0.362) or distant metastasis-free survival (DMFS) (p = 0.548). Lymph node metastasis was found to be a significant prognostic factor in predicting poor LRRFS (p = 0.013) and DMFS (p = 0.021), while the International Federation Gynecology and Obstetrics (FIGO) stage (p = 0.043) was associated with LRRFS.
CONCLUSION
Considering that adjuvant radiotherapy after surgical resection was effective to decrease loco-regional recurrence and most treatment failures were distant metastasis, multimodal therapy including surgery, radiotherapy, and chemotherapy might be an optimal treatment for uterine carcinosarcoma patients.

Keyword

Uterus; Carcinosarcoma; Adjuvant radiotherapy; Treatment failure; Survival

MeSH Terms

Carcinosarcoma
Gynecology
Humans
Hysterectomy
Lymph Nodes
Medical Records
Neoplasm Metastasis
Obstetrics
Radiotherapy, Adjuvant
Recurrence
Retrospective Studies
Survival Rate
Treatment Failure
Uterus