Radiat Oncol J.  2013 Jun;31(2):72-80. 10.3857/roj.2013.31.2.72.

The reasonable timing of the adjuvant radiotherapy in the treatment of uterine carcinosarcoma according to the surgical intent: suggestion based on progression patterns

• Yu JI
• Choi DH
• Huh SJ
• Park W
• Oh D
• Bae DS

• KMID: 2051121
• DOI: http://doi.org/10.3857/roj.2013.31.2.72

Abstract

PURPOSE
We designed this study to identify and suggest the reasonable timing of adjuvant radiotherapy in the treatment of uterine carcinosarcoma according to the surgical intent and patterns of progression.
MATERIALS AND METHODS
We retrospectively analyzed a total of 50 carcinosarcoma patients diagnosed between 1995 and 2010. Among these 50 patients, 32 underwent curative surgery and 13 underwent maximal tumor debulking surgery. The remaining five patients underwent biopsy only. Twenty-six patients received chemotherapy, and 15 patients received adjuvant radiotherapy.
RESULTS
The median follow-up period was 17.3 months. Curative resection (p < 0.001) and stage (p < 0.001) were statistically significant factors affecting survival. During follow-up, 30 patients showed progression. Among these, eight patients (16.0%) had loco-regional progression only. The patients who had received adjuvant radiotherapy did not show loco-regional progression, and radiotherapy was a significant negative risk factor for loco-regional progression (p = 0.01). The time to loco-regional progression was much earlier for non-curative than curative resection (range, 0.7 to 7.6 months vs. 7.5 to 39.0 months).
CONCLUSION
Adjuvant radiotherapy in the treatment of carcinosarcoma might be related to a low loco-regional progression rate. Radiotherapy should be considered in non-curatively resected patients as soon as possible.

Keyword

Carcinosarcoma; Loco-regional progression; Pattern; Radiotherapy; Surgery

MeSH Terms

Biopsy
Carcinosarcoma
Follow-Up Studies
Humans
Radiotherapy, Adjuvant
Retrospective Studies
Risk Factors