Adjuvant radiotherapy improves overall survival when added to surgery and chemotherapy for uterine carcinosarcoma: a surveillance, epidemiology, and end results analysis
| Autor: | Thomas J. Quinn, Bryan S Squires, Sirisha R. Nandalur, M. Saada Jawad |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Univariate analysis business.industry medicine.medical_treatment Hematology General Medicine medicine.disease Surgery Radiation therapy Oncology Surgical oncology Uterine cancer Carcinosarcoma Epidemiology medicine Surveillance Epidemiology and End Results Stage (cooking) business |
| Zdroj: | International Journal of Clinical Oncology. 26:2282-2294 |
| ISSN: | 1437-7772 1341-9625 |
| Popis: | Uterine carcinosarcoma (UCS) confers a high recurrence risk following surgery, and adjuvant chemotherapy (CHT) is typically administered in all stages. The benefit of radiation therapy (RT) in UCS, when added to adjuvant CHT, is unknown. We sought to analyze the Surveillance, Epidemiology, and End Results (SEER) database to ascertain whether RT improves overall survival (OS) when added to surgery and CHT for UCS. SEER 18 Custom Data registries (Nov 2018 submission) were queried for uterine (ICD10 C54.1-9, C55.9) carcinosarcoma (ICD-0-3 8980-3). Patients with stage I-III UCS who underwent surgery and CHT ± RT were analyzed with univariate analysis (UVA) and multivariable analysis (MVA) using Kaplan–Meier and Cox proportional hazards regression modeling. Propensity-score matched analysis with inverse probability of treatment weighting (IPTW) was performed to account for indication bias. Furthermore, conditional landmark analysis (minimum three-month follow-up) was performed to minimize immortal time bias. All 1541 patients (1988–2016) underwent surgery and CHT and 54% received RT. On UVA, RT improved median and 5-year OS from 41 to 87 months and 43–55%, respectively (HR 0.65, 95% CI 0.56–0.77) (p |
| Databáze: | OpenAIRE |
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