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Adjuvant radiotherapy for uterine carcinosarcoma: A retrospective assessment of treatment outcomes

1 Department of Radiation Oncology, Diyarbakir Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkey
2 Department of Radiation Oncology, Ege University Faculty of Medicine, Izmir, Turkey

Correspondence Address:
Ugur Yilmaz,
Department of Radiation Oncology, Diyarbakir Gazi Yasargil Education and Research Hospital, Uckuyu Mah., Kayapinar, Diyarbakir 21010
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcrt.JCRT_531_18

Objectives: The objective of the study is to understand the impact of adjuvant radiotherapy (RT) and prognostic factors for patients diagnosed with uterine carcinosarcoma. Materials and Methods: The records of 31 patients receiving adjuvant RT between the dates of September 2003–January 2013 in our clinic were evaluated retrospectively. Surgery was performed in 27 (87%) patients as staging laparotomy, for 4 patients as total abdominal hysterectomy and bilateral salpingo-oophorectomy. Pelvic external beam radiotherapy (EBRT) was 4500–5040 cGy in 25–28 fractions. In addition, 23 patients received brachytherapy following EBRT, 12 patients received adjuvant, and 1 patient received neoadjuvant chemotherapy (CT). Results: The median age was 63 (between 30 and 78). The stage distribution of the patients was as follows: Stage I, 20 (64%); Stage II, 7 (23%), and Stage III, 4 (13%) patients. Five-year locoregional control (LRC) rate was 100%, disease-free survival (DFS) and overall survival (OS) rates were 65.5% and 66.2%, respectively. Stage I or II patients have a tendency for better 5-year OS and DFS rates than Stage III patients (73.1% vs. 42.9% and 72.7% vs. 42.9%; P = 0.065 and 0.051). Regarding lymph node dissection was performed or not, 5-year OS (64.7% vs. 75.0%) was not statistically different between groups (P = 0.77). Five-year OS and DFS rates were 69.2% and 61.5% for patients receiving CT (adjuvant or neoadjuvant) versus 63.7% and 68.8% for patients not receiving CT; P = 0.63 and P = 0.89, respectively. Based on the analysis of peritoneal washings, 5-year OS was 0% for patients with malignant or suspicious cytology whereas 89% for patients with benign cytology (P = 0.000). A negative correlation was observed between mitotic count of sarcomatous component and DFS time (rs = −0.812 and P = 0.05). Conclusions: Surgery and adjuvant RT seem beneficial for excellent LRC rate. However, survival rates are low due to distant metastases. Thus, there is a great need for better systemic therapies.

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