Dataset Information

Tumor characteristics and outcome of uterine carcinosarcoma in women aged ≥80 years.

ABSTRACT:

Objective

To examine clinico-pathological characteristics and outcomes of uterine carcinosarcoma (UCS) in women aged ≥80 years.

Methods

This is a secondary analysis of a previous multicenter retrospective study examining 906 women with stage I-IV UCS who underwent primary hysterectomy. Patient demographics, treatment types, tumor characteristics, and survival were examined across aged ≥80 (n = 82 [9.1%]), aged 60-79, (n = 526 [58.1%]), and aged <60 (n = 298 [32.9%]).

Results

Women in the aged ≥80 group were more likely to be Caucasian, undergo simple hysterectomy without lymphadenectomy, and receive no postoperative therapy (all, P < 0.05). Tumors in the aged ≥80 group were more likely to have high-grade carcinoma, heterologous sarcoma, and sarcoma dominance but less likely to have lympho-vascular space invasion (all, P < 0.05). Lymphadenectomy did not improve survival in the aged ≥80 group (P > 0.05), whereas lymphadenectomy was protective for survival in the younger groups (both, P < 0.05). Postoperative chemotherapy was associated with improved progression-free survival (PFS) in the aged ≥80 group (hazard ratio [HR] 0.44, 95% confidence interval [CI] 0.22-0.89, P = 0.021). With chemotherapy treatment, women in the aged ≥80 group had PFS similar to those in the aged 60-79 group (HR 0.97, 95%CI 0.51-1.83, P = 0.92). In contrast, without chemotherapy treatment, women in the aged ≥80 group had significantly decreased PFS compared to the aged 60-79 group (HR 1.62, 95%CI 1.09-2.40, P = 0.016). Similar associations were observed for postoperative radiotherapy.

Conclusion

Nearly 10% of women with UCS are aged ≥80 that are characterized by aggressive tumor factors. Postoperative therapy but not extensive surgery may improve survival in this age group.

SUBMITTER: Matsuo K

PROVIDER: S-EPMC7523232 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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Publications

Tumor characteristics and outcome of uterine carcinosarcoma in women aged ≥80 years.

Matsuo Koji K Ross Malcolm S MS Yunokawa Mayu M Johnson Marian S MS Machida Hiroko H Omatsu Kohei K Klobocista Merieme M MM Im Dwight D DD Satoh Shinya S Baba Tsukasa T Ikeda Yuji Y Bush Stephen H SH Hasegawa Kosei K Blake Erin A EA Takekuma Munetaka M Shida Masako M Nishimura Masato M Adachi Sosuke S Pejovic Tanja T Takeuchi Satoshi S Yokoyama Takuhei T Ueda Yutaka Y Iwasaki Keita K Miyake Takahito M TM Yanai Shiori S Nagano Tadayoshi T Takano Tadao T Shahzad Mian Mk MM Ueland Frederick R FR Kelley Joseph L JL Roman Lynda D LD

Surgical oncology 20190207

<h4>Objective</h4>To examine clinico-pathological characteristics and outcomes of uterine carcinosarcoma (UCS) in women aged ≥80 years.<h4>Methods</h4>This is a secondary analysis of a previous multicenter retrospective study examining 906 women with stage I-IV UCS who underwent primary hysterectomy. Patient demographics, treatment types, tumor characteristics, and survival were examined across aged ≥80 (n = 82 [9.1%]), aged 60-79, (n = 526 [58.1%]), and aged <60 (n = 298 [32.9%]).<h4>Results</h ...[more]

PMID: 31196490

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Project description:BackgroundIncidence rates of glioblastoma in very old patients are rising. The standard of care for this cohort is only partially defined and survival remains poor. The aims of this study were to reveal current practice of tumor-specific therapy and supportive care, and to identify predictors for survival in this cohort.MethodsPatients aged 80 years or older at the time of glioblastoma diagnosis were retrospectively identified in 6 clinical centers in Switzerland and France. Demographics, clinical parameters, and survival outcomes were annotated from patient charts. Cox proportional hazards modeling was performed to identify parameters associated with survival.ResultsOf 107 patients, 45 were diagnosed by biopsy, 30 underwent subtotal resection, and 25 had gross total resection. In 7 patients, the extent of resection was not specified. Postoperatively, 34 patients did not receive further tumor-specific treatment. Twelve patients received radiotherapy with concomitant temozolomide, but only 2 patients had maintenance temozolomide therapy. Fourteen patients received temozolomide alone, 35 patients received radiotherapy alone, 1 patient received bevacizumab, and 1 took part in a clinical trial. Median progression-free survival (PFS) was 3.3 months and median overall survival (OS) was 4.2 months. Among patients who received any postoperative treatment, median PFS was 3.9 months and median OS was 7.2 months. Karnofsky performance status (KPS) ≥70%, gross total resection, and combination therapy were associated with better outcomes. The median time spent hospitalized was 30 days, accounting for 23% of the median OS. End-of-life care was mostly provided by nursing homes (n = 20; 32%) and palliative care wards (n = 16; 26%).ConclusionsIn this cohort of very old patients diagnosed with glioblastoma, a large proportion was treated with best supportive care. Treatment beyond surgery and, in particular, combined modality treatment were associated with longer OS and may be considered for selected patients even at higher ages.

Dataset Information

Tumor characteristics and outcome of uterine carcinosarcoma in women aged ≥80 years.

Objective

Methods

Results

Conclusion

Publications

Tumor characteristics and outcome of uterine carcinosarcoma in women aged ≥80 years.

Similar Datasets

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