The role of radiation in improving survival for early-stage carcinosarcoma and leiomyosarcoma
Received 20 December 2007; accepted 9 April 2008. published online 29 May 2008.
Objective
We examined the effect of radiation on survival for early-stage uterine carcinosarcomas and leiomyosarcomas.
Study Design
The surveillance, epidemiology, and end results database was used to identify patients with stage I/II carcinosarcomas and leiomyosarcomas. Logistic regression and Cox models were developed to determine radiation use and survival.
Results
Among 1819 women with carcinosarcomas and 1088 women with leiomyosarcomas, radiation was administered to 667 of the patients (37%) with carcinosarcomas and to 235 of the patients (22%) with leiomyosarcomas. In a multivariate model, adjuvant radiation reduced the risk of death by 21% in women with carcinosarcomas (hazard ratio, 0.79; 95% CI, 0.7-0.9). Radiation reduced mortality rates in patients with carcinosarcomas who had not undergone node dissection but had only a marginal effect on survival in node-negative women. Adjuvant radiation had no effect on survival for early-stage leiomyosarcomas (hazard ratio, 1.1; 95% CI, 0.9-1.4).
Conclusion
Adjuvant radiotherapy improves survival for select patients with early-stage carcinosarcomas but is of limited value for leiomyosarcomas.
aDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY
bDepartment of Biostatistics, Columbia University College of Physicians and Surgeons, New York, NY
cDepartment of Radiation Oncology, Columbia University College of Physicians and Surgeons, New York, NY
dHerbert Irving Comprehensive Cancer Center, New York, NY
Reprints: 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
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.
ABSTRACT
The role of radiation in improving survival for early-stage carcinosarcoma and leiomyosarcoma