The role of radiation in improving survival for early-stage carcinosarcoma and leiomyosarcoma.
OBJECTIVE
We examined the effect of radiation on survival for early-stage uterine carcinosarcomas and leiomyosarcomas.


METHODS
The surveillance, epidemiology, and end results database was used to identify patients with stage I/II carcinosarcomas and leiomyosarcomas. Logistic regression and Cox models were developed to determine radiation use and survival.


RESULTS
Among 1819 women with carcinosarcomas and 1088 women with leiomyosarcomas, radiation was administered to 667 of the patients (37%) with carcinosarcomas and to 235 of the patients (22%) with leiomyosarcomas. In a multivariate model, adjuvant radiation reduced the risk of death by 21% in women with carcinosarcomas (hazard ratio, 0.79; 95% CI, 0.7-0.9). Radiation reduced mortality rates in patients with carcinosarcomas who had not undergone node dissection but had only a marginal effect on survival in node-negative women. Adjuvant radiation had no effect on survival for early-stage leiomyosarcomas (hazard ratio, 1.1; 95% CI, 0.9-1.4).


CONCLUSIONS
Adjuvant radiotherapy improves survival for select patients with early-stage carcinosarcomas but is of limited value for leiomyosarcomas.
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA. jw2459@columbia.edu
Jason D
JD
Wright
Venkatraman E
VE
Seshan
Monjri
M
Shah
Peter B
PB
Schiff
William M
WM
Burke
Carmel J
CJ
Cohen
Thomas J
TJ
Herzog
D000328:Adult; D000368:Aged; D002296:Carcinosarcoma / Q000401:mortality* / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D007890:Leiomyosarcoma / Q000401:mortality* / Q000532:radiotherapy*; D016015:Logistic Models; D008197:Lymph Node Excision; D008875:Middle Aged; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant; D014594:Uterine Neoplasms / Q000401:mortality* / Q000532:radiotherapy*