American Journal of Obstetrics & Gynecology
Volume 199, Issue 5 , Pages 536.e1-536.e8 , November 2008

The role of radiation in improving survival for early-stage carcinosarcoma and leiomyosarcoma

  • Jason D. Wright, MD

      Affiliations

    • Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY
    • Herbert Irving Comprehensive Cancer Center, New York, NY
    • Corresponding Author InformationReprints: Jason D. Wright, MD, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, 161 Fort Washington Ave, 8th Floor, New York, NY 10032
    • ,
  • Venkatraman E. Seshan, PhD

      Affiliations

    • Department of Biostatistics, Columbia University College of Physicians and Surgeons, New York, NY
    • Herbert Irving Comprehensive Cancer Center, New York, NY
    • ,
  • Monjri Shah, MD

      Affiliations

    • Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY
    • Herbert Irving Comprehensive Cancer Center, New York, NY
    • ,
  • Peter B. Schiff, MD, PhD

      Affiliations

    • Department of Radiation Oncology, Columbia University College of Physicians and Surgeons, New York, NY
    • Herbert Irving Comprehensive Cancer Center, New York, NY
    • ,
  • William M. Burke, MD

      Affiliations

    • Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY
    • Herbert Irving Comprehensive Cancer Center, New York, NY
    • ,
  • Carmel J. Cohen, MD

      Affiliations

    • Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY
    • Herbert Irving Comprehensive Cancer Center, New York, NY
    • ,
  • Thomas J. Herzog, MD

      Affiliations

    • Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY
    • Herbert Irving Comprehensive Cancer Center, New York, NY

Received 20 December 2007 ,Accepted 9 April 2008.

References 

  1. Harlow BL, Weiss NS, Lofton S. The epidemiology of sarcomas of the uterus. J Natl Cancer Inst. 1986;76:399–402
  2. Arrastia CD, Fruchter RG, Clark M, et al. Uterine carcinosarcomas: incidence and trends in management and survival. Gynecol Oncol. 1997;65:158–163
  3. Giuntoli RL, Metzinger DS, DiMarco CS, et al. Retrospective review of 208 patients with leiomyosarcoma of the uterus: prognostic indicators, surgical management, and adjuvant therapy. Gynecol Oncol. 2003;89:460–469
  4. Podczaski ES, Woomert CA, Stevens CW, et al. Management of malignant, mixed mesodermal tumors of the uterus. Gynecol Oncol. 1989;32:240–244
  5. Major FJ, Blessing JA, Silverberg SG, et al. Prognostic factors in early-stage uterine sarcoma: a Gynecologic Oncology Group study. Cancer. 1993;71(suppl):1702–1709
  6. Mayerhofer K, Obermair A, Windbichler G, et al. Leiomyosarcoma of the uterus: a clinicopathologic multicenter study of 71 cases. Gynecol Oncol. 1999;74:196–201
  7. Van Dinh T, Woodruff JD. Leiomyosarcoma of the uterus. Am J Obstet Gynecol. 1982;144:817–823
  8. Dinh TV, Slavin RE, Bhagavan BS, Hannigan EV, Tiamson EM, Yandell RB. Mixed Mullerian tumors of the uterus: a clinicopathologic study. Obstet Gynecol. 1989;74:388–392
  9. Kahanpaa KV, Wahlstrom T, Grohn P, Heinonen E, Nieminen U, Widholm O. Sarcomas of the uterus: a clinicopathologic study of 119 patients. Obstet Gynecol. 1986;67:417–424
  10. Nielsen SN, Podratz KC, Scheithauer BW, O'Brien PC. Clinicopathologic analysis of uterine malignant mixed Mullerian tumors. Gynecol Oncol. 1989;34:372–378
  11. Schweizer W, Demopoulos R, Beller U, Dubin N. Prognostic factors for malignant mixed Mullerian tumors of the uterus. Int J Gynecol Pathol. 1990;9:129–136
  12. Callister M, Ramondetta LM, Jhingran A, Burke TW, Eifel PJ. Malignant mixed Mullerian tumors of the uterus: analysis of patterns of failure, prognostic factors, and treatment outcome. Int J Radiat Oncol Biol Phys. 2004;58:786–796
  13. Berchuck A, Rubin SC, Hoskins WJ, Saigo PE, Pierce VK, Lewis JL. Treatment of uterine leiomyosarcoma. Obstet Gynecol. 1988;71:845–850
  14. Tinkler SD, Cowie VJ. Uterine sarcomas: a review of the Edinburgh experience from 1974 to 1992. Br J Radiol. 1993;66:998–1001
  15. Gadducci A, Landoni F, Sartori E, et al. Uterine leiomyosarcoma: analysis of treatment failures and survival. Gynecol Oncol. 1996;62:25–32
  16. Chi DS, Mychalczak B, Saigo PE, Rescigno J, Brown CL. The role of whole-pelvic irradiation in the treatment of early-stage uterine carcinosarcoma. Gynecol Oncol. 1997;65:493–498
  17. Larson B, Silfversward C, Nilsson B, Pettersson F. Mixed Mullerian tumours of the uterus-prognostic factors: a clinical and histopathologic study of 147 cases. Radiother Oncol. 1990;17:123–132
  18. Surveillance, Epidemiology and End Results (SEER) Program, SEER* Stat Database: Incidence-SEER 9 Regs Limited-Use, Nov 2006 Sub (1973-2004), National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch, released April 2007, based on the November 2006 submission. http://seer.cancer.govLast accessed: October 2007
  19. The Surveillance, Epidemiology, and End Results (SEER) Program, Data Quality. National Cancer Institute, 2007. http://seer.cancer.gov/about/Last accessed: October, 2007
  20. Salazar OM, Bonfiglio TA, Patten SF, et al. Uterine sarcomas: analysis of failures with special emphasis on the use of adjuvant radiation therapy. Cancer. 1978;42:1161–1170
  21. Gerszten K, Faul C, Kounelis S, Huang Q, Kelley J, Jones MW. The impact of adjuvant radiotherapy on carcinosarcoma of the uterus. Gynecol Oncol. 1998;68:8–13
  22. Molpus KL, Redlin-Frazier S, Reed G, Burnett LS, Jones HW. Postoperative pelvic irradiation in early-stage uterine mixed Mullerian tumors. Eur J Gynaecol Oncol. 1998;19:541–546
  23. Perez CA, Askin F, Baglan RJ, et al. Effects of irradiation on mixed Mullerian tumors of the uterus. Cancer. 1979;43:1274–1284
  24. Kohorn EI, Schwartz PE, Chambers JT, Peschel RE, Kapp DS, Merino M. Adjuvant therapy in mixed Mullerian tumors of the uterus. Gynecol Oncol. 1986;23:212–221
  25. Knocke TH, Weitmann HD, Kucera H, Kolbl H, Pokrajac B, Potter R. Results of primary and adjuvant radiotherapy in the treatment of mixed Mullerian tumors of the corpus uteri. Gynecol Oncol. 1999;73:389–395
  26. Hornback NB, Omura G, Major FJ. Observations on the use of adjuvant radiation therapy in patients with stage I and II uterine sarcoma. Int J Radiat Oncol Biol Phys. 1986;12:2127–2130
  27. Spanos WJ, Wharton JT, Gomez L, Fletcher GH, Oswald MJ. Malignant mixed Mullerian tumors of the uterus. Cancer. 1984;53:311–316
  28. Yamada SD, Burger RA, Brewster WR, Anton D, Kohler MF, Monk BJ. Pathologic variables and adjuvant therapy as predictors of recurrence and survival for patients with surgically evaluated carcinosarcoma of the uterus. Cancer. 2000;88:2782–2786
  29. George M, Pejovic MH, Kramar A. Uterine sarcomas: prognostic factors and treatment modalities: study on 209 patients. Gynecol Oncol. 1986;24:58–67
  30. Larson B, Silfversward C, Nilsson B, Pettersson F. Prognostic factors in uterine leiomyosarcoma: a clinical and histopathological study of 143 cases: the Radiumhemmet series 1936-1981. Acta Oncol. 1990;29:185–191
  31. Gadducci A, Fabrini MG, Bonuccelli A, et al. Analysis of treatment failures in patients with early-stage uterine leiomyosarcoma. Anticancer Res. 1995;15:485–488
  32. Goff BA, Rice LW, Fleischhacker D, et al. Uterine leiomyosarcoma and endometrial stromal sarcoma: lymph node metastases and sites of recurrence. Gynecol Oncol. 1993;50:105–109
  33. Omura GA, Blessing JA, Major F, et al. A randomized clinical trial of adjuvant adriamycin in uterine sarcomas: a Gynecologic Oncology Group study. J Clin Oncol. 1985;3:1240–1245
  34. McMeekin DS, Sill MW, Darcy KM, et al. A phase II trial of thalidomide in patients with refractory leiomyosarcoma of the uterus and correlation with biomarkers of angiogenesis: a gynecologic oncology group study. Gynecol Oncol. 2007;106:596–603
  35. Miller DS, Blessing JA, Schilder J, Munkarah A, Lee YC. Phase II evaluation of topotecan in carcinosarcoma of the uterus: a Gynecologic Oncology Group study. Gynecol Oncol. 2005;98:217–221
  36. Long HJ, Blessing JA, Sorosky J. Phase II trial of dacarbazine, mitomycin, doxorubicin, and cisplatin with sargramostim in uterine leiomyosarcoma: a Gynecologic Oncology Group study. Gynecol Oncol. 2005;99:339–342
  37. Homesley HD, Filiaci V, Markman M, et al. Phase III trial of ifosfamide with or without paclitaxel in advanced uterine carcinosarcoma: a Gynecologic Oncology Group study. J Clin Oncol. 2007;25:526–531
  38. Hensley ML, Maki R, Venkatraman E, et al. Gemcitabine and docetaxel in patients with unresectable leiomyosarcoma: results of a phase II trial. J Clin Oncol. 2002;20:2824–2831
  39. Anderson S, Aghajanian C. Temozolomide in uterine leiomyosarcomas. Gynecol Oncol. 2005;98:99–103
  40. Wolfson AH, Brady MF, Rocereto T, et al. A gynecologic oncology group randomized phase III trial of whole abdominal irradiation (WAI) vs cisplatin-ifosfamide and mesna (CIM) as post-surgical therapy in stage I-IV carcinosarcoma (CS) of the uterus. Gynecol Oncol. 2007;107:177–185

 Cite this article as: Wright JD, Seshan VE, Shah M, et al. The role of radiation in improving survival for early-stage carcinosarcoma and leiomyosarcoma. Am J Obstet Gynecol 2008;199:536.e1-536.e8.

PII: S0002-9378(08)00410-9

doi: 10.1016/j.ajog.2008.04.019

American Journal of Obstetrics & Gynecology
Volume 199, Issue 5 , Pages 536.e1-536.e8 , November 2008

Article Tools

* Image Usage & Resolution