1. Tumor characteristics and outcome of uterine carcinosarcoma in women aged ≥80 years
- Author
-
Sosuke Adachi, Masato Nishimura, Takahito Miyake, Kosei Hasegawa, Malcolm S. Ross, Tanja Pejovic, Mian M.K. Shahzad, Shiori Yanai, Erin A. Blake, Lynda D. Roman, Joseph L. Kelley, Yutaka Ueda, Tadao Takano, Marian S. Johnson, Merieme Klobocista, Koji Matsuo, Munetaka Takekuma, Mayu Yunokawa, Stephen H. Bush, Masako Shida, Takuhei Yokoyama, Kohei Omatsu, Keita Iwasaki, Tadayoshi Nagano, Hiroko Machida, Shinya Satoh, Satoshi Takeuchi, Yuji Ikeda, Tsukasa Baba, Frederick R. Ueland, and Dwight D. Im
- Subjects
0301 basic medicine ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Hysterectomy ,Article ,03 medical and health sciences ,0302 clinical medicine ,Carcinosarcoma ,Secondary analysis ,Internal medicine ,Adjuvant therapy ,Medicine ,Humans ,Neoplasm Invasiveness ,Uterine carcinosarcoma ,Stage (cooking) ,Aged ,Retrospective Studies ,Simple hysterectomy ,Aged, 80 and over ,business.industry ,Retrospective cohort study ,Middle Aged ,Prognosis ,Combined Modality Therapy ,Survival Rate ,030104 developmental biology ,Oncology ,Chemotherapy, Adjuvant ,030220 oncology & carcinogenesis ,Uterine Neoplasms ,Lymph Node Excision ,Surgery ,Lymphadenectomy ,Female ,Radiotherapy, Adjuvant ,business ,Follow-Up Studies - 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.
- Published
- 2018