Tumor characteristics and outcome of uterine carcinosarcoma in women aged ≥80 years

Koji Matsuo, Malcolm S Ross, Mayu Yunokawa, Marian S Johnson, Hiroko Machida, Kohei Omatsu, Merieme M Klobocista, Dwight D Im, Shinya Satoh, Tsukasa Baba, Yuji Ikeda, Stephen H Bush, Kosei Hasegawa, Erin A Blake, Munetaka Takekuma, Masako Shida, Masato Nishimura, Sosuke Adachi, Tanja Pejovic, Satoshi TakeuchiTakuhei Yokoyama, Yutaka Ueda, Keita Iwasaki, Takahito M Miyake, Shiori Yanai, Tadayoshi Nagano, Tadao Takano, Mian Mk Shahzad, Frederick R Ueland, Joseph L Kelley, Lynda D Roman

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To examine clinico-pathological characteristics and outcomes of uterine carcinosarcoma (UCS) in women aged ≥80 years.

METHODS: This is a secondary analysis of a previous multicenter retrospective study examining 906 women with stage I-IV UCS who underwent primary hysterectomy. Patient demographics, treatment types, tumor characteristics, and survival were examined across aged ≥80 (n = 82 [9.1%]), aged 60-79, (n = 526 [58.1%]), and aged <60 (n = 298 [32.9%]).

RESULTS: Women in the aged ≥80 group were more likely to be Caucasian, undergo simple hysterectomy without lymphadenectomy, and receive no postoperative therapy (all, P < 0.05). Tumors in the aged ≥80 group were more likely to have high-grade carcinoma, heterologous sarcoma, and sarcoma dominance but less likely to have lympho-vascular space invasion (all, P < 0.05). Lymphadenectomy did not improve survival in the aged ≥80 group (P > 0.05), whereas lymphadenectomy was protective for survival in the younger groups (both, P < 0.05). Postoperative chemotherapy was associated with improved progression-free survival (PFS) in the aged ≥80 group (hazard ratio [HR] 0.44, 95% confidence interval [CI] 0.22-0.89, P = 0.021). With chemotherapy treatment, women in the aged ≥80 group had PFS similar to those in the aged 60-79 group (HR 0.97, 95%CI 0.51-1.83, P = 0.92). In contrast, without chemotherapy treatment, women in the aged ≥80 group had significantly decreased PFS compared to the aged 60-79 group (HR 1.62, 95%CI 1.09-2.40, P = 0.016). Similar associations were observed for postoperative radiotherapy.

CONCLUSION: Nearly 10% of women with UCS are aged ≥80 that are characterized by aggressive tumor factors. Postoperative therapy but not extensive surgery may improve survival in this age group.

Original languageEnglish
Pages (from-to)25-32
Number of pages8
JournalSurgical Oncology
Volume29
DOIs
Publication statusPublished - Jun 2019
Externally publishedYes

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Carcinosarcoma
Disease-Free Survival
Confidence Intervals
Neoplasms
Drug Therapy
Survival
Therapeutics
Lymph Node Excision
Hysterectomy
Multicenter Studies
Radiotherapy
Retrospective Studies
Age Groups
Demography

Cite this

Matsuo, K., Ross, M. S., Yunokawa, M., Johnson, M. S., Machida, H., Omatsu, K., ... Roman, L. D. (2019). Tumor characteristics and outcome of uterine carcinosarcoma in women aged ≥80 years. Surgical Oncology, 29, 25-32. https://doi.org/10.1016/j.suronc.2019.02.002

Tumor characteristics and outcome of uterine carcinosarcoma in women aged ≥80 years. / Matsuo, Koji; Ross, Malcolm S; Yunokawa, Mayu; Johnson, Marian S; Machida, Hiroko; Omatsu, Kohei; Klobocista, Merieme M; Im, Dwight D; Satoh, Shinya; Baba, Tsukasa; Ikeda, Yuji; Bush, Stephen H; Hasegawa, Kosei; Blake, Erin A; Takekuma, Munetaka; Shida, Masako; Nishimura, Masato; Adachi, Sosuke; Pejovic, Tanja; Takeuchi, Satoshi; Yokoyama, Takuhei; Ueda, Yutaka; Iwasaki, Keita; Miyake, Takahito M; Yanai, Shiori; Nagano, Tadayoshi; Takano, Tadao; Shahzad, Mian Mk; Ueland, Frederick R; Kelley, Joseph L; Roman, Lynda D.

In: Surgical Oncology, Vol. 29, 06.2019, p. 25-32.

Research output: Contribution to journalArticle

Matsuo, K, Ross, MS, Yunokawa, M, Johnson, MS, Machida, H, Omatsu, K, Klobocista, MM, Im, DD, Satoh, S, Baba, T, Ikeda, Y, Bush, SH, Hasegawa, K, Blake, EA, Takekuma, M, Shida, M, Nishimura, M, Adachi, S, Pejovic, T, Takeuchi, S, Yokoyama, T, Ueda, Y, Iwasaki, K, Miyake, TM, Yanai, S, Nagano, T, Takano, T, Shahzad, MM, Ueland, FR, Kelley, JL & Roman, LD 2019, 'Tumor characteristics and outcome of uterine carcinosarcoma in women aged ≥80 years', Surgical Oncology, vol. 29, pp. 25-32. https://doi.org/10.1016/j.suronc.2019.02.002
Matsuo, Koji ; Ross, Malcolm S ; Yunokawa, Mayu ; Johnson, Marian S ; Machida, Hiroko ; Omatsu, Kohei ; Klobocista, Merieme M ; Im, Dwight D ; Satoh, Shinya ; Baba, Tsukasa ; Ikeda, Yuji ; Bush, Stephen H ; Hasegawa, Kosei ; Blake, Erin A ; Takekuma, Munetaka ; Shida, Masako ; Nishimura, Masato ; Adachi, Sosuke ; Pejovic, Tanja ; Takeuchi, Satoshi ; Yokoyama, Takuhei ; Ueda, Yutaka ; Iwasaki, Keita ; Miyake, Takahito M ; Yanai, Shiori ; Nagano, Tadayoshi ; Takano, Tadao ; Shahzad, Mian Mk ; Ueland, Frederick R ; Kelley, Joseph L ; Roman, Lynda D. / Tumor characteristics and outcome of uterine carcinosarcoma in women aged ≥80 years. In: Surgical Oncology. 2019 ; Vol. 29. pp. 25-32.
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abstract = "OBJECTIVE: To examine clinico-pathological characteristics and outcomes of uterine carcinosarcoma (UCS) in women aged ≥80 years.METHODS: This is a secondary analysis of a previous multicenter retrospective study examining 906 women with stage I-IV UCS who underwent primary hysterectomy. Patient demographics, treatment types, tumor characteristics, and survival were examined across aged ≥80 (n = 82 [9.1{\%}]), aged 60-79, (n = 526 [58.1{\%}]), and aged <60 (n = 298 [32.9{\%}]).RESULTS: Women in the aged ≥80 group were more likely to be Caucasian, undergo simple hysterectomy without lymphadenectomy, and receive no postoperative therapy (all, P < 0.05). Tumors in the aged ≥80 group were more likely to have high-grade carcinoma, heterologous sarcoma, and sarcoma dominance but less likely to have lympho-vascular space invasion (all, P < 0.05). Lymphadenectomy did not improve survival in the aged ≥80 group (P > 0.05), whereas lymphadenectomy was protective for survival in the younger groups (both, P < 0.05). Postoperative chemotherapy was associated with improved progression-free survival (PFS) in the aged ≥80 group (hazard ratio [HR] 0.44, 95{\%} confidence interval [CI] 0.22-0.89, P = 0.021). With chemotherapy treatment, women in the aged ≥80 group had PFS similar to those in the aged 60-79 group (HR 0.97, 95{\%}CI 0.51-1.83, P = 0.92). In contrast, without chemotherapy treatment, women in the aged ≥80 group had significantly decreased PFS compared to the aged 60-79 group (HR 1.62, 95{\%}CI 1.09-2.40, P = 0.016). Similar associations were observed for postoperative radiotherapy.CONCLUSION: Nearly 10{\%} of women with UCS are aged ≥80 that are characterized by aggressive tumor factors. Postoperative therapy but not extensive surgery may improve survival in this age group.",
author = "Koji Matsuo and Ross, {Malcolm S} and Mayu Yunokawa and Johnson, {Marian S} and Hiroko Machida and Kohei Omatsu and Klobocista, {Merieme M} and Im, {Dwight D} and Shinya Satoh and Tsukasa Baba and Yuji Ikeda and Bush, {Stephen H} and Kosei Hasegawa and Blake, {Erin A} and Munetaka Takekuma and Masako Shida and Masato Nishimura and Sosuke Adachi and Tanja Pejovic and Satoshi Takeuchi and Takuhei Yokoyama and Yutaka Ueda and Keita Iwasaki and Miyake, {Takahito M} and Shiori Yanai and Tadayoshi Nagano and Tadao Takano and Shahzad, {Mian Mk} and Ueland, {Frederick R} and Kelley, {Joseph L} and Roman, {Lynda D}",
note = "Copyright {\circledC} 2019 Elsevier Ltd. All rights reserved.",
year = "2019",
month = "6",
doi = "10.1016/j.suronc.2019.02.002",
language = "English",
volume = "29",
pages = "25--32",
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TY - JOUR

T1 - Tumor characteristics and outcome of uterine carcinosarcoma in women aged ≥80 years

AU - Matsuo, Koji

AU - Ross, Malcolm S

AU - Yunokawa, Mayu

AU - Johnson, Marian S

AU - Machida, Hiroko

AU - Omatsu, Kohei

AU - Klobocista, Merieme M

AU - Im, Dwight D

AU - Satoh, Shinya

AU - Baba, Tsukasa

AU - Ikeda, Yuji

AU - Bush, Stephen H

AU - Hasegawa, Kosei

AU - Blake, Erin A

AU - Takekuma, Munetaka

AU - Shida, Masako

AU - Nishimura, Masato

AU - Adachi, Sosuke

AU - Pejovic, Tanja

AU - Takeuchi, Satoshi

AU - Yokoyama, Takuhei

AU - Ueda, Yutaka

AU - Iwasaki, Keita

AU - Miyake, Takahito M

AU - Yanai, Shiori

AU - Nagano, Tadayoshi

AU - Takano, Tadao

AU - Shahzad, Mian Mk

AU - Ueland, Frederick R

AU - Kelley, Joseph L

AU - Roman, Lynda D

N1 - Copyright © 2019 Elsevier Ltd. All rights reserved.

PY - 2019/6

Y1 - 2019/6

N2 - OBJECTIVE: To examine clinico-pathological characteristics and outcomes of uterine carcinosarcoma (UCS) in women aged ≥80 years.METHODS: This is a secondary analysis of a previous multicenter retrospective study examining 906 women with stage I-IV UCS who underwent primary hysterectomy. Patient demographics, treatment types, tumor characteristics, and survival were examined across aged ≥80 (n = 82 [9.1%]), aged 60-79, (n = 526 [58.1%]), and aged <60 (n = 298 [32.9%]).RESULTS: Women in the aged ≥80 group were more likely to be Caucasian, undergo simple hysterectomy without lymphadenectomy, and receive no postoperative therapy (all, P < 0.05). Tumors in the aged ≥80 group were more likely to have high-grade carcinoma, heterologous sarcoma, and sarcoma dominance but less likely to have lympho-vascular space invasion (all, P < 0.05). Lymphadenectomy did not improve survival in the aged ≥80 group (P > 0.05), whereas lymphadenectomy was protective for survival in the younger groups (both, P < 0.05). Postoperative chemotherapy was associated with improved progression-free survival (PFS) in the aged ≥80 group (hazard ratio [HR] 0.44, 95% confidence interval [CI] 0.22-0.89, P = 0.021). With chemotherapy treatment, women in the aged ≥80 group had PFS similar to those in the aged 60-79 group (HR 0.97, 95%CI 0.51-1.83, P = 0.92). In contrast, without chemotherapy treatment, women in the aged ≥80 group had significantly decreased PFS compared to the aged 60-79 group (HR 1.62, 95%CI 1.09-2.40, P = 0.016). Similar associations were observed for postoperative radiotherapy.CONCLUSION: Nearly 10% of women with UCS are aged ≥80 that are characterized by aggressive tumor factors. Postoperative therapy but not extensive surgery may improve survival in this age group.

AB - OBJECTIVE: To examine clinico-pathological characteristics and outcomes of uterine carcinosarcoma (UCS) in women aged ≥80 years.METHODS: This is a secondary analysis of a previous multicenter retrospective study examining 906 women with stage I-IV UCS who underwent primary hysterectomy. Patient demographics, treatment types, tumor characteristics, and survival were examined across aged ≥80 (n = 82 [9.1%]), aged 60-79, (n = 526 [58.1%]), and aged <60 (n = 298 [32.9%]).RESULTS: Women in the aged ≥80 group were more likely to be Caucasian, undergo simple hysterectomy without lymphadenectomy, and receive no postoperative therapy (all, P < 0.05). Tumors in the aged ≥80 group were more likely to have high-grade carcinoma, heterologous sarcoma, and sarcoma dominance but less likely to have lympho-vascular space invasion (all, P < 0.05). Lymphadenectomy did not improve survival in the aged ≥80 group (P > 0.05), whereas lymphadenectomy was protective for survival in the younger groups (both, P < 0.05). Postoperative chemotherapy was associated with improved progression-free survival (PFS) in the aged ≥80 group (hazard ratio [HR] 0.44, 95% confidence interval [CI] 0.22-0.89, P = 0.021). With chemotherapy treatment, women in the aged ≥80 group had PFS similar to those in the aged 60-79 group (HR 0.97, 95%CI 0.51-1.83, P = 0.92). In contrast, without chemotherapy treatment, women in the aged ≥80 group had significantly decreased PFS compared to the aged 60-79 group (HR 1.62, 95%CI 1.09-2.40, P = 0.016). Similar associations were observed for postoperative radiotherapy.CONCLUSION: Nearly 10% of women with UCS are aged ≥80 that are characterized by aggressive tumor factors. Postoperative therapy but not extensive surgery may improve survival in this age group.

U2 - 10.1016/j.suronc.2019.02.002

DO - 10.1016/j.suronc.2019.02.002

M3 - Article

C2 - 31196490

VL - 29

SP - 25

EP - 32

JO - Surgical Oncology

JF - Surgical Oncology

SN - 0960-7404

ER -