Necip Fazil City Hospital, Department of Gynecological Oncology - Kahramanmaraş, Turkey.
Şanlıurfa State Hospital, Department of Gynecological Oncology - Sanlıurfa, Turkey.
Rev Assoc Med Bras (1992). 2023 Sep 18;69(9):e20230517. doi: 10.1590/1806-9282.20230517. eCollection 2023.
Uterine carcinosarcomas are aggressive, rare biphasic tumors with malignant epithelial and malignant sarcomatous components. The prognostic significance of the presence of extrauterine sarcoma (heterologous component) is controversial. Therefore, the aim of this study was to investigate the effect of heterologous components in uterine carcinosarcomas on disease-free survival, overall survival, and other prognostic factors.
Clinical and histopathological data from patients treated for uterine carcinosarcoma in a tertiary cancer center in Turkey between July 2000 and January 2020 were collected. Independent risk factors affecting overall survival and disease-free survival were analyzed by univariate and multivariate Cox regression analyses.
A total of 98 patients were identified. The median follow-up was 21.8 (1.2-233.1) months. In the multivariate analysis, the median overall survival and disease-free survival were 23.8 and 20.7 months in those with homologous mesenchymal components and 17.6 and 9.7 months in those with heterologous mesenchymal components, respectively. It was found that the presence of heterologous mesenchymal components significantly reduced both overall survival and disease-free survival (odds ratio [OR], 2.861; 95% confidence interval [CI] 1.196-6.841; p=0.018 and OR, 3.697; 95%CI 1.572-8.695; p=0.003, respectively). In addition, both lymphadenectomy and adjuvant radiotherapy were found to significantly increase overall survival and disease-free survival. Age was found to increase only disease-free survival.
The results obtained in this study showed that the presence of heterologous components in uterine carcinosarcoma is a prognostic factor that adversely affects both overall survival and disease-free survival. Lymphadenectomy and adjuvant radiotherapy have beneficial effects on both overall survival and disease-free survival.
子宫癌肉瘤是一种侵袭性的罕见的双相肿瘤，具有恶性上皮和恶性肉瘤成分。存在子宫外肉瘤（异源成分）的预后意义存在争议。因此，本研究旨在探讨子宫癌肉瘤中异源成分对无病生存率、总生存率和其他预后因素的影响。
收集 2000 年 7 月至 2020 年 1 月在土耳其一家三级癌症中心治疗的子宫癌肉瘤患者的临床和组织病理学数据。采用单因素和多因素 Cox 回归分析影响总生存率和无病生存率的独立危险因素。
共确定了 98 例患者。中位随访时间为 21.8（1.2-233.1）个月。在多因素分析中，同源间充质成分的中位总生存率和无病生存率分别为 23.8 和 20.7 个月，而异源间充质成分的中位总生存率和无病生存率分别为 17.6 和 9.7 个月。发现存在异源间充质成分显著降低了总生存率和无病生存率（比值比[OR]，2.861；95%置信区间[CI]，1.196-6.841；p=0.018 和 OR，3.697；95%CI，1.572-8.695；p=0.003）。此外，淋巴结切除术和辅助放疗均显著提高了总生存率和无病生存率。年龄仅增加无病生存率。
本研究结果表明，子宫癌肉瘤中存在异源成分是一个预后因素，对总生存率和无病生存率均有不利影响。淋巴结切除术和辅助放疗对总生存率和无病生存率均有有益影响。
