title: The influence of adjuvant radiotherapy on patterns of failure and survivals in uterine carcinosarcoma.
abstract: OBJECTIVE
  To evaluate the impact of postoperative radiotherapy (PORT) on patterns of failure and survivals in uterine carcinosarcoma patients treated with radical surgery.
  
  
  METHODS
  Between October 1998 and August 2010, 19 patients with stage I-III uterine carcinosarcoma received curative hysterectomy and bilateral salpingo-oophorectomy with or without PORT at Seoul National University Hospital. Their hospital medical records were retrospectively reviewed. PORT and non-PORT groups included 11 and 8 patients, respectively. They were followed for a mean of 22.7 months (range, 7.8 to 126.6 months).
  
  
  RESULTS
  At 5 years, the overall survival rates were 51.9% for entire, 61.4% for PORT, and 41.7% for non-PORT groups, respectively. There was no statistical difference between PORT and non-PORT groups with regard to overall survival (p = 0.682). Seven out of 19 (36.8%) patients showed treatment failures, which all happened within 12 months. Although the predominant failures were distant metastasis in PORT group and loco-regional recurrence in non-PORT group, there was no statistically significant difference in loco-regional recurrence-free survival (LRRFS) (p = 0.362) or distant metastasis-free survival (DMFS) (p = 0.548). Lymph node metastasis was found to be a significant prognostic factor in predicting poor LRRFS (p = 0.013) and DMFS (p = 0.021), while the International Federation Gynecology and Obstetrics (FIGO) stage (p = 0.043) was associated with LRRFS.
  
  
  CONCLUSIONS
  Considering that adjuvant radiotherapy after surgical resection was effective to decrease loco-regional recurrence and most treatment failures were distant metastasis, multimodal therapy including surgery, radiotherapy, and chemotherapy might be an optimal treatment for uterine carcinosarcoma patients.
authors.affiliation: Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Hae Jin
authors.initials: HJ
authors.lastname: Park
authors.forename: Hak Jae
authors.initials: HJ
authors.lastname: Kim
authors.forename: Hong-Gyun
authors.initials: HG
authors.lastname: Wu
authors.forename: Hans
authors.initials: H
authors.lastname: Kim
authors.forename: Sung Whan
authors.initials: SW
authors.lastname: Ha
authors.forename: Soon-Beom
authors.initials: SB
authors.lastname: Kang
authors.forename: Yong-Sang
authors.initials: YS
authors.lastname: Song
authors.forename: Noh-Hyun
authors.initials: NH
authors.lastname: Park
authors.forename: Jae-Won
authors.initials: JW
authors.lastname: Kim