FIGO staging for carcinosarcoma: can the revised staging system predict overall survival?
| Autor: | Ghadir Salame, Michael Ablavsky, Ovadia Abulafia, Yi-Chun Lee, E. Stevens, Tana S. Pradhan |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment Mixed Tumor Mullerian Kaplan-Meier Estimate Figo staging Carcinosarcoma medicine Humans Stage (cooking) Uterine Neoplasm Aged Neoplasm Staging Retrospective Studies Aged 80 and over Uterine sarcoma Receiver operating characteristic business.industry Obstetrics and Gynecology Retrospective cohort study Middle Aged medicine.disease Surgery Oncology ROC Curve Uterine Neoplasms Lymphadenectomy Female Radiology business SEER Program |
| Zdroj: | Gynecologic oncology. 123(2) |
| ISSN: | 1095-6859 |
| Popis: | Objectives The purpose of this study is to detect differences in overall survival between the 1988 FIGO staging and current staging of uterine carcinosarcomas to determine if revised 2009 staging accurately predicts actual patient survival. Methods From 1988 until 2010, patients with uterine carcinosarcoma were retrospectively identified from tumor registry records. Patients were grouped in both broad stages (1–4) and all FIGO substages in order to detect differences. Time-dependant receiver operating characteristic curves (ROC) were generated to predict death before the end of the second year post-diagnosis for both the new and revised system. Kaplan Meier estimated median survival time was utilized to compare actual patient survival. Results Of 112 patients with carcinosarcoma, 37 patients (33%) had FIGO Stage I disease, 15 patients (13.4%) had Stage II disease, 36 patients (32%) were diagnosed as Stage III, and 24 patients (21.4%) had Stage IV disease. 106 of 112 (94.6%) patients underwent lymphadenectomy (pelvic +/− para-aortic). Four patients (3.6%) were downstaged when utilizing broad staging criteria: 2 patients were downstaged from Stage II to I, and 2 patients were downstaged from Stage III to Stage I and II respectively. When looking at substage, the area under the ROC was 0.67 for the former staging system, and 0.65 for the revised staging. Kaplan–Meier estimated median survival time post-diagnosis was 610days (95% CI [478,930]). Conclusion Based upon our reclassification of 112 patients with uterine carcinosarcoma, the revised FIGO staging system does not predict survival more accurately than former staging. Carcinosarcoma has an overall poor prognosis and better indicators of survival are needed. |
| Databáze: | OpenAIRE |
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