title: Pathologic prognostic factors in stage I-III uterine carcinosarcoma treated with postoperative radiotherapy.
abstract: OBJECTIVE
  To analyse the impact of prognostic factors on specific overall survival (SOS) after postoperative radiotherapy (P-RT) in carcinosarcomas.
  
  
  METHODS
  We retrospectively analysed 81 patients who received P-RT from 1977 to 2010 after the diagnosis of carcinosarcomas. 2009 FIGO stage: 25-IA, 20-IB, 6-II, 9-IIIA, 11-IIIC. Age, stage, vascular and lymphatic space invasion (VLSI), myometrial invasion, grade, mitotic index, sarcomatous/epithelial components, tumour size and necrosis were considered for the analysis.
  
  
  METHODS
  we used the Kaplan-Meier method for survival analysis and the Cox model for risk factor evaluation.
  
  
  RESULTS
  The mean follow-up of the series was 78.86 months (range 7-381). The median age was 72 years (range 51-89). 30 out 81 (37 %) patients relapsed and died (22.2 % pelvic and abdominal, 13.5 % exclusive distant metastasis). On univariate and multivariate analysis only stage had a significant impact on SOS. At 5 years, stage I-II had a SOS of 66 % in comparison with stage III with 30 %.
  
  
  CONCLUSIONS
  Two groups of patients showing different outcome were found after P-RT in uterine carcinosarcomas: stage I-II patients had a life expectancy 2.5-fold longer compared to stage III patients. New therapeutic strategies are warranted in carcinosarcomas considering the high incidence of distant metastasis.
authors.affiliation: Gynecological Cancer Unit, Radiation Oncology Department, Hospital Clinic, ICMHO, IDIBAPS, University of Barcelona, C/Villarroel 170, 08036, Barcelona, Spain, rovirosa@clinic.ub.es.
authors.forename: Angeles
authors.initials: A
authors.lastname: Rovirosa
authors.forename: Carlos
authors.initials: C
authors.lastname: Ascaso
authors.forename: Meritxell
authors.initials: M
authors.lastname: Arenas
authors.forename: Ivan
authors.initials: I
authors.lastname: Ríos
authors.forename: Marta
authors.initials: M
authors.lastname: Del Pino
authors.forename: Jaume
authors.initials: J
authors.lastname: Ordi
authors.forename: Javier
authors.initials: J
authors.lastname: Morales
authors.forename: Marina
authors.initials: M
authors.lastname: Gascón
authors.forename: Jaume
authors.initials: J
authors.lastname: Pahisa
authors.forename: Albert
authors.initials: A
authors.lastname: Biete
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002296:Carcinosarcoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D016019:Survival Analysis; D014594:Uterine Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery