Significance of Lymphovascular Space Invasion by the Sarcomatous Component in Uterine Carcinosarcoma
Autor: | Shiori Yanai, Erin A. Blake, Masayuki Yoshida, Satoshi Takeuchi, Yoshiaki Yuba, Hiroko Machida, Yutaka Ueda, Hiroshi Kajiwara, Keita Iwasaki, Merieme Klobocista, Masako Shida, Todd B. Sheridan, Terry K. Morgan, Masato Nishimura, Marian S. Johnson, Koji Matsuo, Shinya Satoh, Munetaka Takekuma, Joseph L. Kelley, Esther Elishaev, Tadayoshi Nagano, Abby M. Richmond, Takuya Moriya, Kiyoshi Yoshino, Tanja Pejovic, Malcolm S. Ross, Lynda D. Roman, Takeshi Sasaki, Masanori Yasuda, Mayu Yunokawa, Ardeshir Hakam, Takahito Miyake, Kosei Hasegawa, Tadao Takano, Paulette Mhawech-Fauceglia, Kohei Omatsu, Hiroshi Yoshida, Sosuke Adachi, Stephen H. Bush, Takayuki Enomoto, Miriam D. Post, Tomoyuki Fukagawa, Yuji Ikeda, Takuhei Yokoyama, Yutaka Takazawa, Tsukasa Baba, Mian M.K. Shahzad, Frederick R. Ueland, Dwight D. Im, Rouzan G. Karabakhtsian |
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Rok vydání: | 2018 |
Předmět: |
0301 basic medicine
medicine.medical_specialty Hysterectomy Gastroenterology Article 03 medical and health sciences 0302 clinical medicine Carcinosarcoma Internal medicine medicine Carcinoma Humans Neoplasm Invasiveness Progression-free survival Survival rate Lymphatic Vessels Retrospective Studies business.industry Hazard ratio Middle Aged medicine.disease Primary tumor Progression-Free Survival Lymphovascular Survival Rate 030104 developmental biology Oncology Chemotherapy Adjuvant Lymphatic Metastasis 030220 oncology & carcinogenesis Uterine Neoplasms Disease Progression Blood Vessels Female Radiotherapy Adjuvant Surgery Histopathology Sarcoma business |
Zdroj: | Ann Surg Oncol |
ISSN: | 1534-4681 1068-9265 |
Popis: | OBJECTIVE. The aim of this study was to examine the significance of lymphovascular space invasion (LVSI) with a sarcomatous component on the tumor characteristics and clinical outcomes of women with uterine carcinosarcoma (UCS). METHODS. This was a secondary analysis of a prior multicenter retrospective study that examined women with stage I–IV UCS who underwent primary hysterectomy. Archived histopathology slides were reviewed and LVSI was scored as follows: LVSI with a carcinomatous component alone (LVSI-carcinoma; n = 375, 76.8%) or LVSI containing a sarcomatous component with or without a carcinomatous component (LVSI-sarcoma; n = 113, 23.2%). Qualitative metrics of LVSI were correlated to clinicopathological factors and survival outcome. RESULTS. Tumors in the LVSI-sarcoma group were more likely to have sarcoma dominance (82.1 vs. 26.4%) heterologous sarcomatous component (51.3 vs. 37.9%), low-grade carcinoma (42.5 vs. 22.4%), and large tumor size (81.0 vs. 70.2%) in the primary tumor site compared with tumors in the LVSI-carcinoma group (all p < 0.05). On multivariate analysis, LVSI-sarcoma was independently associated with decreased progression-free survival (5-year rates: 34.9 vs. 40.8%, adjusted hazard ratio [HR] 1.84, 95% confidence interval [CI] 1.36–2.50, p < 0.001), and cause-specific survival (5-year rates: 41.8 vs. 55.9%, adjusted HR 1.95, 95% CI 1.39–2.75, p < 0.001) compared with LVSI-carcinoma. Postoperative radiotherapy for women with LVSI-sarcoma had a higher reduction rate of recurrence/progression of disease (54% reduction, p = 0.04) compared with postoperative radiotherapy for women with LVSI-carcinoma (26% reduction, p = 0.08). CONCLUSION. In UCS, the presence of a sarcomatous component in LVSI is particularly prevalent when a tumor has sarcoma dominance. Our study suggests that LVSI containing a sarcomatous component may be a predictor of decreased survival for women with UCS. |
Databáze: | OpenAIRE |
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