title: Treatment outcomes in completely resected stage I to stage IV uterine carcinosarcoma with rhabdomyosarcoma differentiation.
abstract: OBJECTIVE
  To evaluate overall survival (OS) and progression-free survival (PFS) after adjuvant therapy in stage I to stage IV uterine carcinosarcoma with rhabdomyosarcoma differentiation.
  
  
  METHODS
  Memorial Sloan-Kettering Cancer Center medical records from 1990 to 2012 were reviewed. Patients who received chemotherapy with or without radiation therapy (RT), or RT alone, for completely resected stage I to stage IV uterine carcinosarcoma with rhabdomyosarcoma differentiation were included.
  
  
  RESULTS
  Of 53 patients, International Federation of Gynecology and Obstetrics stage distribution was as follows: I, 13 (24.5%); II, 8 (15.1%); III, 13 (24.5%); and IV, 19 (35.9%). Forty-one (77.4%) of 53 patients received adjuvant chemotherapy, and 34% of the patients who received chemotherapy also received pelvic RT or intravaginal brachytherapy (IVRT). Twelve (22.6%) of the 53 patients received only pelvic RT with/without IVRT. Paclitaxel-carboplatin was the most commonly used adjuvant chemotherapy treatment. The median PFS for the entire cohort was 13.4 months (95% confidence interval [CI], 10.5-17.0). The median OS for the entire cohort was 23.0 months (95% CI, 16.9-34.3). The median PFS periods by stage were 15.9 months for stages I/II versus 11.2 months for stages III/IV (P = 0.012). Median OS was not reached in the early-stage cohort. The median OS for the late-stage cohort was 20.9 months (P = 0.004). The median PFS periods by treatment were 10.4 months for pelvic RT with/without IVRT group versus 13.1 months for chemotherapy with/without pelvic RT with/without IVRT group (P = 0.498). The median OS periods by treatment were 23.6 months for chemotherapy with/without pelvic RT with/without IVRT group versus 16.9 months for pelvic RT with/without IVRT group (P = 0.501).
  
  
  CONCLUSIONS
  The results suggest that chemotherapy alone or in combination with RT is associated with longer PFS and OS compared to RT alone. Only the stage of disease significantly affected PFS and OS.
authors.affiliation: *Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center; †Department of Medicine, Weill Cornell Medical College; ‡Department of Epidemiology and Biostatistics, and §Department of Gynecologic Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY.
authors.forename: Vicky
authors.initials: V
authors.lastname: Makker
authors.forename: Sara J
authors.initials: SJ
authors.lastname: Kravetz
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Gallagher
authors.forename: Oana-Paula
authors.initials: OP
authors.lastname: Orodel
authors.forename: Qin
authors.initials: Q
authors.lastname: Zhou
authors.forename: Alexia
authors.initials: A
authors.lastname: Iasonos
authors.forename: Deborah
authors.initials: D
authors.lastname: DeLair
authors.forename: Carol
authors.initials: C
authors.lastname: Aghajanian
authors.forename: Martee L
authors.initials: ML
authors.lastname: Hensley
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002296:Carcinosarcoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D054338:Cell Transdifferentiation; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D008875:Middle Aged; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D012208:Rhabdomyosarcoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D016019:Survival Analysis; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*