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
Rok vydání: 2018
Předmět:
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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