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Tumor characteristics and outcome of uterine carcinosarcoma in women aged ≥80 years
- Source :
- Surg Oncol
- Publication Year :
- 2018
-
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.
- 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
Subjects
Details
- ISSN :
- 18793320
- Volume :
- 29
- Database :
- OpenAIRE
- Journal :
- Surgical oncology
- Accession number :
- edsair.doi.dedup.....78b0f13cae9f6580c3d34231156c4f70