Department of Obstetrics and Gynecology, Ankara University School of Medicine, Cebeci, 06100, Ankara, Turkey.
Department of Biostatistics, Ankara University School of Medicine, Ankara, Turkey.
Int J Clin Oncol. 2018 Feb;23(1):114-120. doi: 10.1007/s10147-017-1181-3. Epub 2017 Aug 23.
Uterine carcinosarcoma (UCS) is a relatively rare and very aggressive tumor. The predictors of survival for patients with UCS have not been determined clearly yet. The aim of the present study was to investigate the possible predictors of disease-free survival (DFS) and overall survival (OS) for patients with UCS.
All patients with UCS who were treated surgically at a university-based Gynecology Oncology Clinic between January 2008 and December 2014 were recruited into this retrospective cohort study. Data regarding clinical, pathologic and treatment information were obtained retrospectively from hospital records. The Kaplan-Meier method was used to calculate DFS and OS, and Cox regression analysis was performed to define the effects of risk factors on survival.
A total of 88 UCS patients with a median age of 64.5 years were included in the study. Forty-seven (53.4%) patients were diagnosed with stage III disease and seven (7.9%) with stage IV disease. The median follow-up time was 16 months. Among all patients, 60 (68.1%) underwent lymphadenectomy. Optimal cytoreductive surgery was achieved in 67 (76.1%) patients. Stepwise variable selection Cox regression analysis showed that lymph node metastasis was associated with poor DFS (hazard ratio 6.524; 95% CI 2.625-16.211; P < 0.001) and OS (hazard ratio 6.993; 95% CI 2.631-18.587; P < 0.001). Subgroup analysis in both early and advanced-stage diseases revealed no significant impact of risk factors on survival.
Lymph node metastasis is the most significant prognostic factor associated with poor DFS and OS in UCS patients.
子宫癌肉瘤（UCS）是一种相对罕见且极具侵袭性的肿瘤。目前尚未明确预测 UCS 患者生存情况的因素。本研究旨在探讨可能影响 UCS 患者无病生存（DFS）和总生存（OS）的预测因素。
本回顾性队列研究纳入了 2008 年 1 月至 2014 年 12 月在一所大学妇科肿瘤诊所接受手术治疗的所有 UCS 患者。通过病历回顾性收集临床、病理和治疗信息。采用 Kaplan-Meier 法计算 DFS 和 OS，并采用 Cox 回归分析定义危险因素对生存的影响。
共纳入 88 例 UCS 患者，中位年龄为 64.5 岁。47 例（53.4%）患者诊断为 III 期疾病，7 例（7.9%）为 IV 期疾病。中位随访时间为 16 个月。所有患者中，60 例（68.1%）接受了淋巴结切除术。67 例（76.1%）患者实现了最佳减瘤手术。逐步变量选择 Cox 回归分析显示，淋巴结转移与较差的 DFS（风险比 6.524；95%CI 2.625-16.211；P<0.001）和 OS（风险比 6.993；95%CI 2.631-18.587；P<0.001）相关。在早期和晚期疾病亚组分析中，危险因素对生存的影响无显著差异。
淋巴结转移是与 UCS 患者较差的 DFS 和 OS 最显著相关的预后因素。
