Clinical significance of radiotherapy in patients with primary uterine carcinosarcoma: A multicenter retrospective study (KROG 13-08)

Jihye Cha, Young Seok Kim, Won Park, Hak Jae Kim, Joo Young Kim, Jin Hee Kim, Juree Kim, Won Sup Yoon, Jun Won Kim, Yong Bae Kim

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objective: To investigate the role of radiotherapy (RT) in patients who underwent hysterectomy for uterine carcinosarcoma (UCS). Methods: Patients with the International Federation of Gynecology and Obstetrics stage I- IVa UCS who were treated between 1990 and 2012 were identified retrospectively in a multi-institutional database. Of 235 identified patients, 97 (41.3%) received adjuvant RT. Twenty-two patients with a history of previous pelvic RT were analyzed separately. Survival outcomes were assessed using the Kaplan-Meier method and Cox proportional hazards model. Results: Patients with a previous history of pelvic RT had poor survival outcomes, and 72.6% of these patients experienced locoregional recurrence; however, none received RT after a diagnosis of UCS. Univariate analyses revealed that pelvic lymphadenectomy (PLND) and para-aortic lymph node sampling were significant factors for locoregional recurrence-free survival (LRRFS) and disease-free survival (DFS). Among patients without previous pelvic RT, the percentage of locoregional failure was lower for those who received adjuvant RT than for those who did not (28.5% vs. 17.5%, p=0.107). Multivariate analysis revealed significant correlations between PLND and LRRFS, distant metastasis-free survival, and DFS. In subgroup analyses, RT significantly improved the 5-year LRRFS rate of patients who did not undergo PLND (52.7% vs. 18.7% for non-RT, p<0.001). Conclusion: Adjuvant RT decreased the risk of locoregional recurrence after hysterectomy for UCS, particularly in patients without surgical nodal staging. Given the poorer locoregional outcomes of patients previously subjected to pelvic RT, meticulous re-administration of RT might improve locoregional control while leading to less toxicity in these patients.

Original languageEnglish
Article numbere58
JournalJournal of Gynecologic Oncology
Volume27
Issue number6
DOIs
Publication statusPublished - 2016 Nov

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Carcinosarcoma
Multicenter Studies
Radiotherapy
Retrospective Studies
Adjuvant Radiotherapy
Recurrence
Hysterectomy
Disease-Free Survival
Survival
Lymph Node Excision
Gynecology
Proportional Hazards Models
Obstetrics
Multivariate Analysis
Survival Rate
Lymph Nodes

All Science Journal Classification (ASJC) codes

  • Oncology
  • Obstetrics and Gynaecology

Cite this

Cha, Jihye ; Kim, Young Seok ; Park, Won ; Kim, Hak Jae ; Kim, Joo Young ; Kim, Jin Hee ; Kim, Juree ; Yoon, Won Sup ; Kim, Jun Won ; Kim, Yong Bae. / Clinical significance of radiotherapy in patients with primary uterine carcinosarcoma : A multicenter retrospective study (KROG 13-08). In: Journal of Gynecologic Oncology. 2016 ; Vol. 27, No. 6.
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title = "Clinical significance of radiotherapy in patients with primary uterine carcinosarcoma: A multicenter retrospective study (KROG 13-08)",
abstract = "Objective: To investigate the role of radiotherapy (RT) in patients who underwent hysterectomy for uterine carcinosarcoma (UCS). Methods: Patients with the International Federation of Gynecology and Obstetrics stage I- IVa UCS who were treated between 1990 and 2012 were identified retrospectively in a multi-institutional database. Of 235 identified patients, 97 (41.3{\%}) received adjuvant RT. Twenty-two patients with a history of previous pelvic RT were analyzed separately. Survival outcomes were assessed using the Kaplan-Meier method and Cox proportional hazards model. Results: Patients with a previous history of pelvic RT had poor survival outcomes, and 72.6{\%} of these patients experienced locoregional recurrence; however, none received RT after a diagnosis of UCS. Univariate analyses revealed that pelvic lymphadenectomy (PLND) and para-aortic lymph node sampling were significant factors for locoregional recurrence-free survival (LRRFS) and disease-free survival (DFS). Among patients without previous pelvic RT, the percentage of locoregional failure was lower for those who received adjuvant RT than for those who did not (28.5{\%} vs. 17.5{\%}, p=0.107). Multivariate analysis revealed significant correlations between PLND and LRRFS, distant metastasis-free survival, and DFS. In subgroup analyses, RT significantly improved the 5-year LRRFS rate of patients who did not undergo PLND (52.7{\%} vs. 18.7{\%} for non-RT, p<0.001). Conclusion: Adjuvant RT decreased the risk of locoregional recurrence after hysterectomy for UCS, particularly in patients without surgical nodal staging. Given the poorer locoregional outcomes of patients previously subjected to pelvic RT, meticulous re-administration of RT might improve locoregional control while leading to less toxicity in these patients.",
author = "Jihye Cha and Kim, {Young Seok} and Won Park and Kim, {Hak Jae} and Kim, {Joo Young} and Kim, {Jin Hee} and Juree Kim and Yoon, {Won Sup} and Kim, {Jun Won} and Kim, {Yong Bae}",
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language = "English",
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Clinical significance of radiotherapy in patients with primary uterine carcinosarcoma : A multicenter retrospective study (KROG 13-08). / Cha, Jihye; Kim, Young Seok; Park, Won; Kim, Hak Jae; Kim, Joo Young; Kim, Jin Hee; Kim, Juree; Yoon, Won Sup; Kim, Jun Won; Kim, Yong Bae.

In: Journal of Gynecologic Oncology, Vol. 27, No. 6, e58, 11.2016.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinical significance of radiotherapy in patients with primary uterine carcinosarcoma

T2 - A multicenter retrospective study (KROG 13-08)

AU - Cha, Jihye

AU - Kim, Young Seok

AU - Park, Won

AU - Kim, Hak Jae

AU - Kim, Joo Young

AU - Kim, Jin Hee

AU - Kim, Juree

AU - Yoon, Won Sup

AU - Kim, Jun Won

AU - Kim, Yong Bae

PY - 2016/11

Y1 - 2016/11

N2 - Objective: To investigate the role of radiotherapy (RT) in patients who underwent hysterectomy for uterine carcinosarcoma (UCS). Methods: Patients with the International Federation of Gynecology and Obstetrics stage I- IVa UCS who were treated between 1990 and 2012 were identified retrospectively in a multi-institutional database. Of 235 identified patients, 97 (41.3%) received adjuvant RT. Twenty-two patients with a history of previous pelvic RT were analyzed separately. Survival outcomes were assessed using the Kaplan-Meier method and Cox proportional hazards model. Results: Patients with a previous history of pelvic RT had poor survival outcomes, and 72.6% of these patients experienced locoregional recurrence; however, none received RT after a diagnosis of UCS. Univariate analyses revealed that pelvic lymphadenectomy (PLND) and para-aortic lymph node sampling were significant factors for locoregional recurrence-free survival (LRRFS) and disease-free survival (DFS). Among patients without previous pelvic RT, the percentage of locoregional failure was lower for those who received adjuvant RT than for those who did not (28.5% vs. 17.5%, p=0.107). Multivariate analysis revealed significant correlations between PLND and LRRFS, distant metastasis-free survival, and DFS. In subgroup analyses, RT significantly improved the 5-year LRRFS rate of patients who did not undergo PLND (52.7% vs. 18.7% for non-RT, p<0.001). Conclusion: Adjuvant RT decreased the risk of locoregional recurrence after hysterectomy for UCS, particularly in patients without surgical nodal staging. Given the poorer locoregional outcomes of patients previously subjected to pelvic RT, meticulous re-administration of RT might improve locoregional control while leading to less toxicity in these patients.

AB - Objective: To investigate the role of radiotherapy (RT) in patients who underwent hysterectomy for uterine carcinosarcoma (UCS). Methods: Patients with the International Federation of Gynecology and Obstetrics stage I- IVa UCS who were treated between 1990 and 2012 were identified retrospectively in a multi-institutional database. Of 235 identified patients, 97 (41.3%) received adjuvant RT. Twenty-two patients with a history of previous pelvic RT were analyzed separately. Survival outcomes were assessed using the Kaplan-Meier method and Cox proportional hazards model. Results: Patients with a previous history of pelvic RT had poor survival outcomes, and 72.6% of these patients experienced locoregional recurrence; however, none received RT after a diagnosis of UCS. Univariate analyses revealed that pelvic lymphadenectomy (PLND) and para-aortic lymph node sampling were significant factors for locoregional recurrence-free survival (LRRFS) and disease-free survival (DFS). Among patients without previous pelvic RT, the percentage of locoregional failure was lower for those who received adjuvant RT than for those who did not (28.5% vs. 17.5%, p=0.107). Multivariate analysis revealed significant correlations between PLND and LRRFS, distant metastasis-free survival, and DFS. In subgroup analyses, RT significantly improved the 5-year LRRFS rate of patients who did not undergo PLND (52.7% vs. 18.7% for non-RT, p<0.001). Conclusion: Adjuvant RT decreased the risk of locoregional recurrence after hysterectomy for UCS, particularly in patients without surgical nodal staging. Given the poorer locoregional outcomes of patients previously subjected to pelvic RT, meticulous re-administration of RT might improve locoregional control while leading to less toxicity in these patients.

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