Prognostic Impact of the History of Breast Cancer and of Hormone Therapy in Uterine Carcinosarcoma
Prognostic Impact of the History of Breast Cancer and of Hormone Therapy in Uterine Carcinosarcoma
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DOI：
10.1097/igc.0b013e31823c3219
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发表时间：
2012-02-01
影响因子：
4.8
通讯作者：
Kasamatsu, Takahiro
中科院分区：
文献类型：
--
作者：
Uehara, Takashi;Onda, Takashi;Kasamatsu, Takahiro
目的：最近的研究揭示了激素治疗乳腺癌（BC），如他莫昔芬（TAM）和托瑞米芬（TOR）与子宫癌肉瘤（UCS）之间的关系。本研究的目的是探讨BC和激素治疗后UCS患者的特点和预后。方法：1997年1月至2007年12月，我们治疗了51例UCS患者。回顾了这些患者的医疗记录，并采用单因素和多因素分析对影响其生存的因素进行回顾性分析。结果：51例患者中有10例（19.6%）有BC病史；6例（11.8%）接受了TAM或TOR的激素治疗。UCS患者的特征是相似的，无论他们是否有BC病史或激素治疗。在单因素分析中，年龄大于56岁、血清乳酸脱氢酶水平升高、残留肿瘤、FIGO（国际妇产联合会）分期高于IIIa期和非子宫内膜样癌成分被确定为预后因素。在多因素分析中，除了残余肿瘤、FIGO分期高于IIIa期和非子宫内膜癌成分外，BC病史（相对风险，0.14）、TAM使用史（相对风险，15.9）和TOR使用史（相对风险，16.9）也被确定为独立的显著预后因素。结论：我们的数据表明，BC病史和激素治疗是发生UCS的危险因素，但对UCS的特征没有明显影响。这两种因素对UCS患者预后的影响均有统计学意义。需要进一步的研究来澄清和验证这些关联。
Objective: Recent studies reveal an association between hormone therapy for breast cancer (BC), such as tamoxifen (TAM) and toremifene (TOR), and uterine carcinosarcoma (UCS). The aim of this study was to investigate the characteristics and prognosis of patients with UCS after BC and hormone therapy.Methods: Between January 1997 and December 2007, we treated 51 patients with UCS. The medical records of these patients were reviewed, and factors that influenced their survival were retrospectively analyzed using univariate and multivariate analyses.Results: Ten (19.6%) of the 51 patients had a history of BC; 6 (11.8%) had received hormone therapy with TAM or TOR. The characteristics of the patients with UCS were similar regardless of whether they had a history of BC or hormone therapy. On univariate analysis, age greater than 56 years, elevated serum lactate dehydrogenase levels, residual tumors, FIGO (International Federation of Gynecology and Obstetrics) stage higher than stage IIIa, and non-endometrioid carcinomatous components were identified as prognostic factors. On multivariate analysis, in addition to residual tumors, FIGO stage higher than stage IIIa, and non-endometrioid carcinomatous components, a history of BC (relative risk, 0.14), a history of TAM use (relative risk, 15.9), and a history of TOR use (relative risk, 16.9) were also identified as independently significant prognostic factors.Conclusions: Our data suggest that a history of BC and hormone therapy for BC is a risk factor for developing UCS without obvious impacts on the characteristics of UCS. Both of these factors had statistically significant impacts on the prognosis of patients with UCS. Further studies are necessary to clarify and validate these associations.