title: Postoperative pelvic irradiation in early stage uterine mixed mullerian tumors.
abstract: OBJECTIVE
  To review our management experience with uterine mixed mullerian tumors (MMTs) in order to evaluate potential prognostic indicators, and assess the efficacy of various treatment modalities.
  
  
  METHODS
  A retrospective, clinicopathologic evaluation of 43 patients presenting for treatment of uterine MMTs between 1982 and 1992 was conducted. Diagnostic criteria for inclusion was the presence of both a malignant glandular or squamous epithelial component, and a homologous or heterologous stromal component.
  
  
  RESULTS
  Overall 2- and 5-year cancer related Kaplan-Meier survival estimates with 95% confidence intervals were 44 (.28, .59) and 26% [.12, .39], respectively. Survivals were 83 [.62, .99] and 58% [.31, .85] when disease was confined to the uterus, and 22 [.03, .41] and 7% [.01, .20] when disease extended beyond the uterus. Clinical staging was often inaccurate, with 29% of clinical stage I or II disease being upstaged at laparotomy. A significant survival advantage was found in patients with stage I or II disease treated with surgery plus pelvic irradiation (p = 0.001), as compared to those treated with surgery alone. The prognosis after disease recurrence was poor, irrespective of secondary therapy, with a median survival of 11 months.
  
  
  CONCLUSIONS
  A therapeutic advantage may be gained from postoperative pelvic irradiation in the treatment of surgical stage I or II uterine MMT.
authors.affiliation: Department of Obstetrics and Gynecology, Vanderbilt University School of Medicine, Nashville, Tennessee 37232-2516, USA.
authors.forename: K L
authors.initials: KL
authors.lastname: Molpus
authors.forename: S
authors.initials: S
authors.lastname: Redlin-Frazier
authors.forename: G
authors.initials: G
authors.lastname: Reed
authors.forename: L S
authors.initials: LS
authors.lastname: Burnett
authors.forename: H W
authors.initials: HW
authors.lastname: Jones
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016001:Confidence Intervals; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007813:Laparotomy; D008875:Middle Aged; D018200:Mixed Tumor, Mullerian / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D009367:Neoplasm Staging; D010388:Pelvis / Q000528:radiation effects; D011379:Prognosis; D018714:Radiotherapy, Adjuvant / Q000379:methods; D012189:Retrospective Studies; D015996:Survival Rate; D014594:Uterine Neoplasms / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery