Evaluation of prognostic factors and treatment outcomes in uterine carcinosarcoma
Evaluation of prognostic factors and treatment outcomes in uterine carcinosarcoma
复制标题
DOI：
10.1016/j.ejogrb.2008.12.014
复制
发表时间：
2009-04-01
影响因子：
2.6
通讯作者：
Edmondson, R. J.
中科院分区：
文献类型：
--
作者：
Galaal, K.;Kew, F. M.;Edmondson, R. J.
目的：本研究的目的是确定的预后因素，生存结果和辅助治疗的妇女子宫癌肉瘤治疗在一个单一的institution.Study设计：这是一个队列研究的妇女诊断为癌肉瘤和治疗在北方妇科肿瘤中心，伊丽莎白女王医院，Gateshead，英国。回顾性分析1960年1月至2002年7月间诊断为癌肉瘤的所有患者的病历。中位年龄为67岁。最常见的临床表现是阴道异常出血，占85%，其次是盆腔包块，占45%，腹痛占38%。在手术中有54%的妇女子宫外扩散。中位随访时间为33个月（范围4 - 146个月）。辅助治疗与生存优势无关。55名患者（59%）被诊断为复发，所有阶段的总5年生存率为33%。多变量分析子宫肌层浸润深度，阶段和盆腔淋巴结转移与生存差。结论：这些患者的不良结局可能反映了癌肉瘤的侵袭性，并在介绍时超过50%的子宫外疾病，这是与显着较差的生存。全身辅助治疗与结局的显著改善无关。需要更多的研究来更好地确定这种罕见癌症的适当治疗方法。(C)2009爱思唯尔爱尔兰有限公司保留所有权利。
Objective: The aims of this study were to determine the prognostic factors, survival outcomes and response to adjuvant therapy in women with uterine carcinosarcoma treated in a single institution.Study design: This is a cohort study of women diagnosed with carcinosarcoma and treated at the Northern Gynaecological Oncology Centre, Queen Elizabeth Hospital, Gateshead, UK. The medical records of all patients diagnosed with carcinosarcoma between January 1960 and July 2002 were reviewed.Results: A total of 93 women were identified during this period. The median age was 67 years. The most common presentation was abnormal vaginal bleeding, occurring in 85%, followed by pelvic mass in 45%, and abdominal pain in 38%. At surgery there was extra-uterine spread in 54% of women. The median follow-up was 33 months (range 4-146 months). Adjuvant therapy was not associated with survival advantage. Recurrence was diagnosed in 55 patients (59%) and the overall 5-year survival for all stages was 33%. On multivariate analysis depth of myometrial invasion, stage and pelvic nodes metastasis were associated with poor survival.Conclusion: The poor outcome for these patients may reflect the aggressive nature of carcinosarcoma and that at the time of presentation more than 50% have extra-uterine disease, which was associated with significant poorer survival. Systemic adjuvant therapy has not been associated with significant improvement in the outcome. More studies are needed to better define the appropriate treatment for this rare cancer. (C) 2009 Elsevier Ireland Ltd. All rights reserved.