Optimal cytoreductive surgery in patients with advanced uterine carcinosarcoma: A multi-institutional retrospective study from the Japanese gynecologic oncology group

Kenichi Harano, Akihiro Hirakawa, Mayu Yunokawa, Toshiaki Nakamura, Toyomi Satoh, Tadaaki Nishikawa, Daisuke Aoki, Kimihiko Ito, Kiyoshi Ito, Toru Nakanishi, Nobuyuki Susumu, Kazuhiro Takehara, Yoh Watanabe, Hidemichi Watari, Toshiaki Saito

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: The benefits of cytoreductive surgery for uterine carcinosarcoma (UCS) are unknown. The objective of this study was to determine the impact of optimal surgery on advanced UCS patient survival. Methods: We performed a multi-institutional, retrospective study of women diagnosed with stage III. IV UCS between 2007 and 2012. Data were obtained retrospectively from medical records, including demographic, clinicopathologic, treatment, and outcome information. Optimal cytoreductive surgery was defined as surgery resulting in a maximum residual tumor of ≤. 1. cm. The Kaplan-Meier method was used to calculate progression-free survival (PFS) and overall survival (OS), and the Cox regression model was used to examine the impact of selected factors on survival. Results: A total of 225 UCS patients (median age, 63. years) were identified, including 136 (60%) with stage III and 89 (40%) with stage IV disease. Among these patients, 170 (76%) received optimal cytoreductive surgery. The median follow-up time was 19. months. The median PFS was 11.5. months (95% confidence interval [CI], 10.6-13.4) and 8.1. months (95% CI, 5.1-9.5) for patients who received optimal and suboptimal cytoreductive surgery, respectively (P. . 1. cm was associated with worse OS while pelvic lymph node dissection was associated with improved OS. Conclusion: Optimal cytoreductive surgery and pelvic lymph node dissection are associated with improved OS in advanced UCS patients.

Original languageEnglish
JournalGynecologic Oncology
DOIs
Publication statusAccepted/In press - 2015 Dec 15

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Carcinosarcoma
Retrospective Studies
Survival
Lymph Node Excision
Disease-Free Survival
Confidence Intervals
Residual Neoplasm
Proportional Hazards Models
Medical Records
Demography

Keywords

  • Cytoreductive surgery
  • Pelvic lymph node dissection
  • Uterine carcinosarcoma

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Oncology

Cite this

Optimal cytoreductive surgery in patients with advanced uterine carcinosarcoma : A multi-institutional retrospective study from the Japanese gynecologic oncology group. / Harano, Kenichi; Hirakawa, Akihiro; Yunokawa, Mayu; Nakamura, Toshiaki; Satoh, Toyomi; Nishikawa, Tadaaki; Aoki, Daisuke; Ito, Kimihiko; Ito, Kiyoshi; Nakanishi, Toru; Susumu, Nobuyuki; Takehara, Kazuhiro; Watanabe, Yoh; Watari, Hidemichi; Saito, Toshiaki.

In: Gynecologic Oncology, 15.12.2015.

Research output: Contribution to journalArticle

Harano, K, Hirakawa, A, Yunokawa, M, Nakamura, T, Satoh, T, Nishikawa, T, Aoki, D, Ito, K, Ito, K, Nakanishi, T, Susumu, N, Takehara, K, Watanabe, Y, Watari, H & Saito, T 2015, 'Optimal cytoreductive surgery in patients with advanced uterine carcinosarcoma: A multi-institutional retrospective study from the Japanese gynecologic oncology group', Gynecologic Oncology. https://doi.org/10.1016/j.ygyno.2016.04.004
Harano, Kenichi ; Hirakawa, Akihiro ; Yunokawa, Mayu ; Nakamura, Toshiaki ; Satoh, Toyomi ; Nishikawa, Tadaaki ; Aoki, Daisuke ; Ito, Kimihiko ; Ito, Kiyoshi ; Nakanishi, Toru ; Susumu, Nobuyuki ; Takehara, Kazuhiro ; Watanabe, Yoh ; Watari, Hidemichi ; Saito, Toshiaki. / Optimal cytoreductive surgery in patients with advanced uterine carcinosarcoma : A multi-institutional retrospective study from the Japanese gynecologic oncology group. In: Gynecologic Oncology. 2015.
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abstract = "Background: The benefits of cytoreductive surgery for uterine carcinosarcoma (UCS) are unknown. The objective of this study was to determine the impact of optimal surgery on advanced UCS patient survival. Methods: We performed a multi-institutional, retrospective study of women diagnosed with stage III. IV UCS between 2007 and 2012. Data were obtained retrospectively from medical records, including demographic, clinicopathologic, treatment, and outcome information. Optimal cytoreductive surgery was defined as surgery resulting in a maximum residual tumor of ≤. 1. cm. The Kaplan-Meier method was used to calculate progression-free survival (PFS) and overall survival (OS), and the Cox regression model was used to examine the impact of selected factors on survival. Results: A total of 225 UCS patients (median age, 63. years) were identified, including 136 (60{\%}) with stage III and 89 (40{\%}) with stage IV disease. Among these patients, 170 (76{\%}) received optimal cytoreductive surgery. The median follow-up time was 19. months. The median PFS was 11.5. months (95{\%} confidence interval [CI], 10.6-13.4) and 8.1. months (95{\%} CI, 5.1-9.5) for patients who received optimal and suboptimal cytoreductive surgery, respectively (P. . 1. cm was associated with worse OS while pelvic lymph node dissection was associated with improved OS. Conclusion: Optimal cytoreductive surgery and pelvic lymph node dissection are associated with improved OS in advanced UCS patients.",
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AU - Hirakawa, Akihiro

AU - Yunokawa, Mayu

AU - Nakamura, Toshiaki

AU - Satoh, Toyomi

AU - Nishikawa, Tadaaki

AU - Aoki, Daisuke

AU - Ito, Kimihiko

AU - Ito, Kiyoshi

AU - Nakanishi, Toru

AU - Susumu, Nobuyuki

AU - Takehara, Kazuhiro

AU - Watanabe, Yoh

AU - Watari, Hidemichi

AU - Saito, Toshiaki

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N2 - Background: The benefits of cytoreductive surgery for uterine carcinosarcoma (UCS) are unknown. The objective of this study was to determine the impact of optimal surgery on advanced UCS patient survival. Methods: We performed a multi-institutional, retrospective study of women diagnosed with stage III. IV UCS between 2007 and 2012. Data were obtained retrospectively from medical records, including demographic, clinicopathologic, treatment, and outcome information. Optimal cytoreductive surgery was defined as surgery resulting in a maximum residual tumor of ≤. 1. cm. The Kaplan-Meier method was used to calculate progression-free survival (PFS) and overall survival (OS), and the Cox regression model was used to examine the impact of selected factors on survival. Results: A total of 225 UCS patients (median age, 63. years) were identified, including 136 (60%) with stage III and 89 (40%) with stage IV disease. Among these patients, 170 (76%) received optimal cytoreductive surgery. The median follow-up time was 19. months. The median PFS was 11.5. months (95% confidence interval [CI], 10.6-13.4) and 8.1. months (95% CI, 5.1-9.5) for patients who received optimal and suboptimal cytoreductive surgery, respectively (P. . 1. cm was associated with worse OS while pelvic lymph node dissection was associated with improved OS. Conclusion: Optimal cytoreductive surgery and pelvic lymph node dissection are associated with improved OS in advanced UCS patients.

AB - Background: The benefits of cytoreductive surgery for uterine carcinosarcoma (UCS) are unknown. The objective of this study was to determine the impact of optimal surgery on advanced UCS patient survival. Methods: We performed a multi-institutional, retrospective study of women diagnosed with stage III. IV UCS between 2007 and 2012. Data were obtained retrospectively from medical records, including demographic, clinicopathologic, treatment, and outcome information. Optimal cytoreductive surgery was defined as surgery resulting in a maximum residual tumor of ≤. 1. cm. The Kaplan-Meier method was used to calculate progression-free survival (PFS) and overall survival (OS), and the Cox regression model was used to examine the impact of selected factors on survival. Results: A total of 225 UCS patients (median age, 63. years) were identified, including 136 (60%) with stage III and 89 (40%) with stage IV disease. Among these patients, 170 (76%) received optimal cytoreductive surgery. The median follow-up time was 19. months. The median PFS was 11.5. months (95% confidence interval [CI], 10.6-13.4) and 8.1. months (95% CI, 5.1-9.5) for patients who received optimal and suboptimal cytoreductive surgery, respectively (P. . 1. cm was associated with worse OS while pelvic lymph node dissection was associated with improved OS. Conclusion: Optimal cytoreductive surgery and pelvic lymph node dissection are associated with improved OS in advanced UCS patients.

KW - Cytoreductive surgery

KW - Pelvic lymph node dissection

KW - Uterine carcinosarcoma

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