Department of Radiation Oncology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, China.
Department of General Surgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, China.
Cancer Med. 2022 Jul;11(14):2846-2854. doi: 10.1002/cam4.4643. Epub 2022 Mar 11.
The potential therapeutic benefit of adjuvant radiotherapy for patients with stage I uterine sarcoma has not been clear. In this study, we aimed to develop a risk scoring model to select the subgroup of patients with stage I uterine sarcoma who might benefit from adjuvant radiotherapy.
Patients with stage I uterine sarcoma from the Surveillance, Epidemiology, and End Results program from 2010 to 2014 were retrospectively included in this analysis. Cox proportional hazards models were performed to identify risk factors.
A total of 947 stage I uterine sarcoma patients were included. The 5-year disease-specific survival (DSS) of the overall cohort was 75.81%. Multivariate analysis identified stage (p = 0.013), tumor grade (p <0.001) and histology (p = 0.043) as independent prognostic factors for DSS, and these factors were used to generate the risk scoring model. The low-risk group presented a better DSS than the high-risk group (95.51% vs. 49.88%, p < 0.001). The addition of radiotherapy to surgery significantly increased the DSS in the high-risk group compared with surgery alone (78.06% vs. 46.88%, p = 0.022), but no significant survival benefit was observed in the low-risk group (98.36% vs. 100%, p = 0.766).
Our risk scoring model based on stage, tumor grade, and histology predicted the outcome of patients with stage I uterine sarcoma cancer. This system may help to select stage I uterine sarcoma cancer patients who might benefit from adjuvant radiotherapy.
辅助放疗对 I 期子宫肉瘤患者的潜在治疗益处尚不清楚。本研究旨在建立一个风险评分模型，以选择可能从辅助放疗中获益的 I 期子宫肉瘤患者亚组。
回顾性分析了 2010 年至 2014 年来自监测、流行病学和最终结果计划的 I 期子宫肉瘤患者。采用 Cox 比例风险模型确定危险因素。
共纳入 947 例 I 期子宫肉瘤患者。全队列的 5 年疾病特异性生存率（DSS）为 75.81%。多因素分析确定分期（p=0.013）、肿瘤分级（p<0.001）和组织学（p=0.043）是 DSS 的独立预后因素，并将这些因素用于生成风险评分模型。低危组的 DSS 明显优于高危组（95.51% vs. 49.88%，p<0.001）。与单纯手术相比，放疗联合手术显著提高了高危组的 DSS（78.06% vs. 46.88%，p=0.022），但在低危组未观察到生存获益（98.36% vs. 100%，p=0.766）。
基于分期、肿瘤分级和组织学的风险评分模型预测了 I 期子宫肉瘤患者的结局。该系统可能有助于选择可能从辅助放疗中获益的 I 期子宫肉瘤患者。
