The influence of adjuvant radiotherapy on patterns of failure and survivals in uterine carcinosarcoma
Identifieur interne : 004A57 ( Main/Exploration ); précédent : 004A56; suivant : 004A58The influence of adjuvant radiotherapy on patterns of failure and survivals in uterine carcinosarcoma
Auteurs : Hae Jin Park [Corée du Sud] ; Hak Jae Kim [Corée du Sud] ; Hong-Gyun Wu [Corée du Sud] ; Hans Kim [Corée du Sud] ; Sung Whan Ha [Corée du Sud] ; Soon-Beom Kang [Corée du Sud] ; Yong-Sang Song [Corée du Sud] ; Noh-Hyun Park [Corée du Sud] ; Jae-Won Kim [Corée du Sud]Source :
- Radiation Oncology Journal [ 2234-1900 ] ; 2011.
Abstract
To evaluate the impact of postoperative radiotherapy (PORT) on patterns of failure and survivals in uterine carcinosarcoma patients treated with radical surgery.
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).
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.
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.
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DOI: 10.3857/roj.2011.29.4.228
PubMed: 22984675
PubMed Central: 3429907
Affiliations:
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Yong Sang" sort="Song, Yong Sang" uniqKey="Song Y" first="Yong-Sang" last="Song">Yong-Sang Song</name><affiliation wicri:level="3"><nlm:aff id="A4">Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Park, Noh Hyun" sort="Park, Noh Hyun" uniqKey="Park N" first="Noh-Hyun" last="Park">Noh-Hyun Park</name><affiliation wicri:level="3"><nlm:aff id="A4">Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Obstetrics and 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wicri:level="3"><nlm:aff id="A1">Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Radiation Oncology, Seoul National University College of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Wu, Hong Gyun" sort="Wu, Hong Gyun" uniqKey="Wu H" first="Hong-Gyun" last="Wu">Hong-Gyun Wu</name><affiliation wicri:level="3"><nlm:aff id="A1">Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Radiation Oncology, Seoul National University College of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation><affiliation wicri:level="4"><nlm:aff id="A2">Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region><settlement type="city">Séoul</settlement></placeName><orgName type="university">Université nationale de Séoul</orgName></affiliation><affiliation wicri:level="3"><nlm:aff id="A3">Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Cancer Research Institute, Seoul National University College of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Kim, Hans" sort="Kim, Hans" uniqKey="Kim H" first="Hans" last="Kim">Hans Kim</name><affiliation wicri:level="3"><nlm:aff id="A1">Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Radiation Oncology, Seoul National University College of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Ha, Sung Whan" sort="Ha, Sung Whan" uniqKey="Ha S" first="Sung Whan" last="Ha">Sung Whan Ha</name><affiliation wicri:level="3"><nlm:aff id="A1">Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Radiation Oncology, Seoul National University College of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation><affiliation wicri:level="4"><nlm:aff id="A2">Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region><settlement type="city">Séoul</settlement></placeName><orgName type="university">Université nationale de Séoul</orgName></affiliation><affiliation wicri:level="3"><nlm:aff id="A3">Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Cancer Research Institute, Seoul National University College of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Kang, Soon Beom" sort="Kang, Soon Beom" uniqKey="Kang S" first="Soon-Beom" last="Kang">Soon-Beom Kang</name><affiliation wicri:level="3"><nlm:aff id="A4">Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Song, Yong Sang" sort="Song, Yong Sang" uniqKey="Song Y" first="Yong-Sang" last="Song">Yong-Sang Song</name><affiliation wicri:level="3"><nlm:aff id="A4">Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Park, Noh Hyun" sort="Park, Noh Hyun" uniqKey="Park N" first="Noh-Hyun" last="Park">Noh-Hyun Park</name><affiliation wicri:level="3"><nlm:aff id="A4">Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Kim, Jae Won" sort="Kim, Jae Won" uniqKey="Kim J" first="Jae-Won" last="Kim">Jae-Won Kim</name><affiliation wicri:level="3"><nlm:aff id="A4">Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author></analytic><series><title level="j">Radiation Oncology Journal</title><idno type="ISSN">2234-1900</idno><idno type="eISSN">2234-3164</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Purpose</title><p>To evaluate the impact of postoperative radiotherapy (PORT) on patterns of failure and survivals in uterine carcinosarcoma patients treated with radical surgery.</p></sec><sec><title>Materials and Methods</title><p>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).</p></sec><sec><title>Results</title><p>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.</p></sec><sec><title>Conclusion</title><p>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.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Arrastia, Cd" uniqKey="Arrastia C">CD Arrastia</name></author><author><name sortKey="Fruchter, Rg" uniqKey="Fruchter R">RG Fruchter</name></author><author><name sortKey="Clark, M" uniqKey="Clark M">M Clark</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Pothuri, B" 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Setser</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Makker, V" uniqKey="Makker V">V Makker</name></author><author><name sortKey="Abu Rustum, Nr" uniqKey="Abu Rustum N">NR Abu-Rustum</name></author><author><name sortKey="Alektiar, Km" uniqKey="Alektiar K">KM Alektiar</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sartori, E" uniqKey="Sartori E">E Sartori</name></author><author><name sortKey="Bazzurini, L" uniqKey="Bazzurini L">L Bazzurini</name></author><author><name sortKey="Gadducci, A" uniqKey="Gadducci A">A Gadducci</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wolfson, Ah" uniqKey="Wolfson A">AH Wolfson</name></author><author><name sortKey="Brady, Mf" uniqKey="Brady M">MF Brady</name></author><author><name sortKey="Rocereto, T" uniqKey="Rocereto T">T Rocereto</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Clayton Smith, D" uniqKey="Clayton Smith D">D Clayton Smith</name></author><author><name sortKey="Kenneth Macdonald, O" uniqKey="Kenneth Macdonald O">O Kenneth Macdonald</name></author><author><name sortKey="Gaffney, Dk" uniqKey="Gaffney D">DK Gaffney</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wong, L" uniqKey="Wong L">L Wong</name></author><author><name sortKey="See, Ht" uniqKey="See H">HT See</name></author><author><name sortKey="Khoo Tan, Hs" uniqKey="Khoo Tan H">HS Khoo-Tan</name></author><author><name sortKey="Low, Js" uniqKey="Low J">JS Low</name></author><author><name sortKey="Ng, Wt" uniqKey="Ng W">WT Ng</name></author><author><name sortKey="Low, Jj" uniqKey="Low J">JJ Low</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Manolitsas, Tp" uniqKey="Manolitsas T">TP Manolitsas</name></author><author><name sortKey="Wain, Gv" uniqKey="Wain G">GV Wain</name></author><author><name sortKey="Williams, Ke" uniqKey="Williams K">KE Williams</name></author><author><name sortKey="Freidlander, M" uniqKey="Freidlander M">M Freidlander</name></author><author><name sortKey="Hacker, Nf" uniqKey="Hacker N">NF Hacker</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Menczer, J" uniqKey="Menczer J">J Menczer</name></author><author><name sortKey="Levy, T" uniqKey="Levy T">T Levy</name></author><author><name sortKey="Piura, B" uniqKey="Piura B">B Piura</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Yamada, Sd" uniqKey="Yamada S">SD Yamada</name></author><author><name sortKey="Burger, Ra" uniqKey="Burger R">RA Burger</name></author><author><name sortKey="Brewster, Wr" uniqKey="Brewster W">WR Brewster</name></author><author><name sortKey="Anton, D" uniqKey="Anton D">D Anton</name></author><author><name sortKey="Kohler, Mf" uniqKey="Kohler M">MF Kohler</name></author><author><name sortKey="Monk, Bj" uniqKey="Monk B">BJ Monk</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Corée du Sud</li></country><region><li>Région capitale de Séoul</li></region><settlement><li>Séoul</li></settlement><orgName><li>Université nationale de Séoul</li></orgName></list><tree><country name="Corée du Sud"><region name="Région capitale de Séoul"><name sortKey="Park, Hae Jin" sort="Park, Hae Jin" uniqKey="Park H" first="Hae Jin" last="Park">Hae Jin Park</name></region><name sortKey="Ha, Sung Whan" sort="Ha, Sung Whan" uniqKey="Ha S" first="Sung Whan" last="Ha">Sung Whan Ha</name><name sortKey="Ha, Sung Whan" sort="Ha, Sung Whan" uniqKey="Ha S" first="Sung Whan" last="Ha">Sung Whan Ha</name><name sortKey="Ha, Sung Whan" sort="Ha, Sung Whan" uniqKey="Ha S" first="Sung Whan" last="Ha">Sung Whan Ha</name><name sortKey="Kang, Soon Beom" sort="Kang, Soon Beom" uniqKey="Kang S" first="Soon-Beom" last="Kang">Soon-Beom Kang</name><name sortKey="Kim, Hak Jae" sort="Kim, Hak Jae" uniqKey="Kim H" first="Hak Jae" last="Kim">Hak Jae Kim</name><name sortKey="Kim, Hans" sort="Kim, Hans" uniqKey="Kim H" first="Hans" last="Kim">Hans Kim</name><name sortKey="Kim, Jae Won" sort="Kim, Jae Won" uniqKey="Kim J" first="Jae-Won" last="Kim">Jae-Won Kim</name><name sortKey="Park, Noh Hyun" sort="Park, Noh Hyun" uniqKey="Park N" first="Noh-Hyun" last="Park">Noh-Hyun Park</name><name sortKey="Song, Yong Sang" sort="Song, Yong Sang" uniqKey="Song Y" first="Yong-Sang" last="Song">Yong-Sang Song</name><name sortKey="Wu, Hong Gyun" sort="Wu, Hong Gyun" uniqKey="Wu H" first="Hong-Gyun" last="Wu">Hong-Gyun Wu</name><name sortKey="Wu, Hong Gyun" sort="Wu, Hong Gyun" uniqKey="Wu H" first="Hong-Gyun" last="Wu">Hong-Gyun Wu</name><name sortKey="Wu, Hong Gyun" sort="Wu, Hong Gyun" uniqKey="Wu H" first="Hong-Gyun" last="Wu">Hong-Gyun Wu</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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