Uterine Carcinosarcoma: Clinicopathological Features and Prognostic Factors

Detalhes bibliográficos
Autor(a) principal: Luz, Rita
Data de Publicação: 2016
Outros Autores: Ferreira, Joana, Rocha, Mara, Jorge, Ana Francisca, Félix, Ana
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7078
Resumo: Introduction: Uterine carcinosarcoma is a rare and aggressive biphasic malignancy and is currently included in the high risk endometrial carcinoma group. The aims of this study were to determine the clinicopathological profile, treatment, recurrence/progression patterns, survival and prognostic factors.Material and Methods: Retrospective study of 42 patients, surgically staged and followed-up at a cancer centre, between 2005 and 2013. Clinical data was retrieved from records and pathological characteristics were reviewed for this study.Results: Median age was 72 years (61 - 78) and the majority presented comorbid diseases. Stage distribution as follows: 13 (31.0%) stage I; eight (19.0%) stage II; nine (21.4%) stage III; and 12 (28.6%) stage IV. Chemotherapy was instituted in 12 patients and 21 received radiotherapy. Disease progressed in 16 patients and recurred in nine after a short interval. Median overall survival was 18 months (6.8 - 40) and median disease-free survival was 6 months (0 – 22.8). The only independent prognostic factor related with poor survival was serosal invasion (p = 0.02; HR adjusted 4.22; IC 95% 1.29 – 13.79).Discussion: In accordance to other studies, diagnosis of uterine carcinosarcoma is frequently done with advanced disease and presents a high rate of progression/recurrence. The variable which has been consistently identified as main prognostic factor is stage, but in this study the only independent factor was serosal invasion.Conclusion: The present study represents the larger series of uterine carcinosarcoma studied in Portugal and reflects the clinical presentation, histopathological characteristics and stage at diagnosis and confirms the aggressiveness of this rare tumor.
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spelling Uterine Carcinosarcoma: Clinicopathological Features and Prognostic FactorsCarcinossarcoma Uterino: Características ClinicoPatológicas e Fatores de PrognósticoCarcinosarcomaNeoplasm StagingPrognosisSurvival RateUterine Neoplasms.CarcinossarcomaEstadiamento de NeoplasiasNeoplasias UterinasPrognósticoTaxa de Sobrevida.Introduction: Uterine carcinosarcoma is a rare and aggressive biphasic malignancy and is currently included in the high risk endometrial carcinoma group. The aims of this study were to determine the clinicopathological profile, treatment, recurrence/progression patterns, survival and prognostic factors.Material and Methods: Retrospective study of 42 patients, surgically staged and followed-up at a cancer centre, between 2005 and 2013. Clinical data was retrieved from records and pathological characteristics were reviewed for this study.Results: Median age was 72 years (61 - 78) and the majority presented comorbid diseases. Stage distribution as follows: 13 (31.0%) stage I; eight (19.0%) stage II; nine (21.4%) stage III; and 12 (28.6%) stage IV. Chemotherapy was instituted in 12 patients and 21 received radiotherapy. Disease progressed in 16 patients and recurred in nine after a short interval. Median overall survival was 18 months (6.8 - 40) and median disease-free survival was 6 months (0 – 22.8). The only independent prognostic factor related with poor survival was serosal invasion (p = 0.02; HR adjusted 4.22; IC 95% 1.29 – 13.79).Discussion: In accordance to other studies, diagnosis of uterine carcinosarcoma is frequently done with advanced disease and presents a high rate of progression/recurrence. The variable which has been consistently identified as main prognostic factor is stage, but in this study the only independent factor was serosal invasion.Conclusion: The present study represents the larger series of uterine carcinosarcoma studied in Portugal and reflects the clinical presentation, histopathological characteristics and stage at diagnosis and confirms the aggressiveness of this rare tumor.Introdução: O carcinossarcoma uterino é uma neoplasia bifásica rara e agressiva e está atualmente incluído no grupo de carcinoma do endométrio de alto risco. Os objetivos deste estudo foram determinar o perfil clinico-patológico, tratamento, padrões de recidiva/progressão, sobrevivência e fatores de prognóstico.Material e Métodos: Estudo retrospetivo de 42 doentes, estadiadas cirurgicamente e vigiadas num centro oncológico, entre 2005 e 2013. Os dados clínicos foram consultados nos processos e as características histopatológicas foram revistas para este estudo.Resultados: A idade mediana das doentes foi de 72 anos (61 - 81) e a maioria apresentava co-morbilidades. A distribuição por estádio foi a seguinte: 13 (31,0%) estádio I; oito (19,0%) estádio II; nove (21,4%) estádio III; e 12 (28,6%) estádio IV. A quimioterapia adjuvante foi instituída em 12 doentes e 21 realizaram radioterapia. A doença progrediu em 16 doentes e recidivou em nove após um intervalo curto. A sobrevivência global mediana foi de 18 meses (6,8 - 40) e a sobrevivência livre de doença mediana de 6 meses (0 - 22,8). O único fator prognóstico independente associado a pior sobrevivência foi a invasão da serosa (p = 0,02; HR ajustado 4,22; IC 95% 1,29 - 13,79).Discussão: Em concordância com outros estudos, o diagnóstico de carcinossarcoma uterino é frequentemente realizado com doença avançada e apresenta elevada taxa de progressão/recidiva. A variável que tem sido consistentemente identificada como principal fator de prognóstico é o estádio inicial, mas neste estudo o único fator independente foi a invasão da serosa.Conclusão: O presente estudo representa a maior série de carcinossarcoma uterino estudada em Portugal e reflete o quadro clínico,características histopatológicas e estádio no momento do diagnóstico e confirma a agressividade deste raro tumor.Ordem dos Médicos2016-10-31info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfimage/jpegapplication/mswordapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7078oai:ojs.www.actamedicaportuguesa.com:article/7078Acta Médica Portuguesa; Vol. 29 No. 10 (2016): October; 621-628Acta Médica Portuguesa; Vol. 29 N.º 10 (2016): Outubro; 621-6281646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7078https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7078/4785https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7078/7986https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7078/8436https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7078/8477Direitos de Autor (c) 2016 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessLuz, RitaFerreira, JoanaRocha, MaraJorge, Ana FranciscaFélix, Ana2022-12-20T11:05:05Zoai:ojs.www.actamedicaportuguesa.com:article/7078Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:19:24.593481Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Uterine Carcinosarcoma: Clinicopathological Features and Prognostic Factors
Carcinossarcoma Uterino: Características ClinicoPatológicas e Fatores de Prognóstico
title Uterine Carcinosarcoma: Clinicopathological Features and Prognostic Factors
spellingShingle Uterine Carcinosarcoma: Clinicopathological Features and Prognostic Factors
Luz, Rita
Carcinosarcoma
Neoplasm Staging
Prognosis
Survival Rate
Uterine Neoplasms.
Carcinossarcoma
Estadiamento de Neoplasias
Neoplasias Uterinas
Prognóstico
Taxa de Sobrevida.
title_short Uterine Carcinosarcoma: Clinicopathological Features and Prognostic Factors
title_full Uterine Carcinosarcoma: Clinicopathological Features and Prognostic Factors
title_fullStr Uterine Carcinosarcoma: Clinicopathological Features and Prognostic Factors
title_full_unstemmed Uterine Carcinosarcoma: Clinicopathological Features and Prognostic Factors
title_sort Uterine Carcinosarcoma: Clinicopathological Features and Prognostic Factors
author Luz, Rita
author_facet Luz, Rita
Ferreira, Joana
Rocha, Mara
Jorge, Ana Francisca
Félix, Ana
author_role author
author2 Ferreira, Joana
Rocha, Mara
Jorge, Ana Francisca
Félix, Ana
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Luz, Rita
Ferreira, Joana
Rocha, Mara
Jorge, Ana Francisca
Félix, Ana
dc.subject.por.fl_str_mv Carcinosarcoma
Neoplasm Staging
Prognosis
Survival Rate
Uterine Neoplasms.
Carcinossarcoma
Estadiamento de Neoplasias
Neoplasias Uterinas
Prognóstico
Taxa de Sobrevida.
topic Carcinosarcoma
Neoplasm Staging
Prognosis
Survival Rate
Uterine Neoplasms.
Carcinossarcoma
Estadiamento de Neoplasias
Neoplasias Uterinas
Prognóstico
Taxa de Sobrevida.
description Introduction: Uterine carcinosarcoma is a rare and aggressive biphasic malignancy and is currently included in the high risk endometrial carcinoma group. The aims of this study were to determine the clinicopathological profile, treatment, recurrence/progression patterns, survival and prognostic factors.Material and Methods: Retrospective study of 42 patients, surgically staged and followed-up at a cancer centre, between 2005 and 2013. Clinical data was retrieved from records and pathological characteristics were reviewed for this study.Results: Median age was 72 years (61 - 78) and the majority presented comorbid diseases. Stage distribution as follows: 13 (31.0%) stage I; eight (19.0%) stage II; nine (21.4%) stage III; and 12 (28.6%) stage IV. Chemotherapy was instituted in 12 patients and 21 received radiotherapy. Disease progressed in 16 patients and recurred in nine after a short interval. Median overall survival was 18 months (6.8 - 40) and median disease-free survival was 6 months (0 – 22.8). The only independent prognostic factor related with poor survival was serosal invasion (p = 0.02; HR adjusted 4.22; IC 95% 1.29 – 13.79).Discussion: In accordance to other studies, diagnosis of uterine carcinosarcoma is frequently done with advanced disease and presents a high rate of progression/recurrence. The variable which has been consistently identified as main prognostic factor is stage, but in this study the only independent factor was serosal invasion.Conclusion: The present study represents the larger series of uterine carcinosarcoma studied in Portugal and reflects the clinical presentation, histopathological characteristics and stage at diagnosis and confirms the aggressiveness of this rare tumor.
publishDate 2016
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7078/4785
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7078/7986
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dc.rights.driver.fl_str_mv Direitos de Autor (c) 2016 Acta Médica Portuguesa
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dc.publisher.none.fl_str_mv Ordem dos Médicos
publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 29 No. 10 (2016): October; 621-628
Acta Médica Portuguesa; Vol. 29 N.º 10 (2016): Outubro; 621-628
1646-0758
0870-399X
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