Rauh-Hain J Alejandro, Shoni Melina, Schorge John O, Goodman Annekathryn, Horowitz Neil S, del Carmen Marcela G
Division of Gynecologic Oncology, Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Yawkey 9E, Boston, MA 02114, USA.
J Reprod Med. 2013 Jul-Aug;58(7-8):297-304.
To analyze and compare the demographics, treatment, recurrence, and survival rates in patients with carcinosarcoma of the uterus and ovary.
All patients with uterine and ovarian carcinosarcoma who underwent surgical staging at the 2 participating institutions between 1995 and 2007 were identified. The Kaplan-Meier method was used to generate overall survival (OS) data. Factors predictive of outcome were compared using the Cox proportional hazards model.
Analysis of 87 women with uterine carcinosarcoma and 71 with ovarian carcinosarcoma was performed. Of those, 47% of the patients with uterine carcinosarcoma, compared to 14% of the patients with ovarian carcinosarcoma, were diagnosed with localized disease (p < 0.001). Age > 65 years old (p < 0.001), tumor extension (local versus regional versus distant, p < 0.001), and platinum-based chemotherapy (p = 0.05) were all independent predictors of survival. In a multivariate Cox regression model, age > 65 years old (hazard ratio [HR] = 2.5, p < 0.001), tumor extension (locoregional versus distant, HR = 3.9, p = 0.006), and uterine versus ovarian carcinosarcoma (HR = 2.2, p = 0.009) were identified as independent predictors of OS.
Uterine carcinosarcoma presents at an earlier stage than does ovarian carcinosarcoma. In the multivariate analysis uterine carcinosarcoma demonstrated shorter survival than did ovarian carcinosarcoma after adjustment for extent of disease spread, age, and platinum-based chemotherapy.
分析并比较子宫和卵巢癌肉瘤患者的人口统计学特征、治疗情况、复发率及生存率。
确定1995年至2007年间在2家参与研究的机构接受手术分期的所有子宫和卵巢癌肉瘤患者。采用Kaplan-Meier法生成总生存（OS）数据。使用Cox比例风险模型比较预测预后的因素。
对87例子宫癌肉瘤患者和71例卵巢癌肉瘤患者进行了分析。其中，47%的子宫癌肉瘤患者被诊断为局限性疾病，而卵巢癌肉瘤患者中这一比例为14%（p<0.001）。年龄>65岁（p<0.001）、肿瘤扩展情况（局部、区域或远处，p<0.001）以及铂类化疗（p=0.05）均为生存的独立预测因素。在多变量Cox回归模型中，年龄>65岁（风险比[HR]=2.5，p<0.001）、肿瘤扩展情况（局部区域与远处，HR=3.9，p=0.006）以及子宫与卵巢癌肉瘤（HR=2.2，p=0.009）被确定为OS的独立预测因素。
子宫癌肉瘤比卵巢癌肉瘤出现的阶段更早。在多变量分析中，调整疾病扩散范围、年龄和铂类化疗后，子宫癌肉瘤的生存期比卵巢癌肉瘤短。
