Characterizing sarcoma dominance pattern in uterine carcinosarcoma: Homologous versus heterologous element

Koji Matsuo, Yutaka Takazawa, Malcolm S. Ross, Esther Elishaev, Mayu Yunokawa, Todd B. Sheridan, Stephen H. Bush, Merieme M. Klobocista, Erin A. Blake, Tadao Takano, Tsukasa Baba, Shinya Satoh, Masako Shida, Yuji Ikeda, Sosuke Adachi, Takuhei Yokoyama, Munetaka Takekuma, Shiori Yanai, Satoshi Takeuchi, Masato NishimuraKeita Iwasaki, Marian S. Johnson, Masayuki Yoshida, Ardeshir Hakam, Hiroko Machida, Paulette Mhawech-Fauceglia, Yutaka Ueda, Kiyoshi Yoshino, Hiroshi Kajiwara, Kosei Hasegawa, Masanori Yasuda, Takahito M. Miyake, Takuya Moriya, Yoshiaki Yuba, Terry Morgan, Tomoyuki Fukagawa, Tanja Pejovic, Tadayoshi Nagano, Takeshi Sasaki, Abby M. Richmond, Miriam D. Post, Mian M.K. Shahzad, Dwight D. Im, Hiroshi Yoshida, Kohei Omatsu, Frederick R. Ueland, Joseph L. Kelley, Rouzan G. Karabakhtsian, Lynda D. Roman

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Objective: To examine significance of sarcoma dominance (SD) patterns in uterine carcinosarcoma (UCS). Methods: This is a secondary analysis of multicenter retrospective study examining women with stages I-IV UCS who underwent primary surgery. SD was defined as >50% of sarcoma component in uterine tumor. SD patterns were grouped as homologous sarcoma without SD (homo/non-dominance, n = 351), heterologous sarcoma without SD (hetero/non-dominance, n = 174), homologous sarcoma with SD (homo/dominance, n = 175), and heterologous sarcoma with SD (hetero/dominance, n = 189), and correlated to tumor characteristics and survival. Results: SD patterns were significantly associated with age, body habitus, carcinoma type, tumor size, depth of myometrial invasion, and nodal metastasis (all, P < 0.05). On univariate analysis, SD was associated with decreased progression-free survival (PFS) and cause-specific survival (CSS) in homologous cases (both, P < 0.05) but not in heterologous cases. On multivariate models, both homologous and heterologous SD patterns remained independent prognostic factors for decreased PFS (adjusted-hazard ratio [HR] ranges: homo/dominance 1.35–1.69, and hetero/dominance 1.47–1.64) and CSS (adjusted-HR ranges: 1.52–1.84 and 1.66–1.81, respectively) compared to homo/non-dominance (all, P < 0.05). Among stage I-III disease, when tumors had SD, adding radiotherapy to chemotherapy was significantly associated with improved PFS (adjusted-HR: homo/dominance 0.49, and hetero/dominance 0.45) and CSS (0.36 and 0.31, respectively) compared to chemotherapy alone (all, P < 0.05); contrary, this association was not observed with absence of SD (all, P > 0.05). Conclusion: In UCS, SD impacts survival in homologous but not in heterologous type. Regardless of sarcoma types, SD was associated with decreased survival in UCS; adding radiotherapy to chemotherapy may be an effective postoperative strategy.

Original languageEnglish (US)
Pages (from-to)433-440
Number of pages8
JournalSurgical Oncology
Volume27
Issue number3
DOIs
StatePublished - Sep 2018

Keywords

  • Heterologous
  • Homologous
  • Sarcoma dominance
  • Survival
  • Uterine carcinosarcoma

ASJC Scopus subject areas

  • Surgery
  • Oncology

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    Matsuo, K., Takazawa, Y., Ross, M. S., Elishaev, E., Yunokawa, M., Sheridan, T. B., Bush, S. H., Klobocista, M. M., Blake, E. A., Takano, T., Baba, T., Satoh, S., Shida, M., Ikeda, Y., Adachi, S., Yokoyama, T., Takekuma, M., Yanai, S., Takeuchi, S., ... Roman, L. D. (2018). Characterizing sarcoma dominance pattern in uterine carcinosarcoma: Homologous versus heterologous element. Surgical Oncology, 27(3), 433-440. https://doi.org/10.1016/j.suronc.2018.05.017