ABSTRACT
SUMMARY OBJECTIVE: Uterine carcinosarcomas are aggressive, rare biphasic tumors with malignant epithelial and malignant sarcomatous components. The prognostic significance of the presence of extrauterine sarcoma (heterologous component) is controversial. Therefore, the aim of this study was to investigate the effect of heterologous components in uterine carcinosarcomas on disease-free survival, overall survival, and other prognostic factors. METHODS: Clinical and histopathological data from patients treated for uterine carcinosarcoma in a tertiary cancer center in Turkey between July 2000 and January 2020 were collected. Independent risk factors affecting overall survival and disease-free survival were analyzed by univariate and multivariate Cox regression analyses. RESULTS: A total of 98 patients were identified. The median follow-up was 21.8 (1.2-233.1) months. In the multivariate analysis, the median overall survival and disease-free survival were 23.8 and 20.7 months in those with homologous mesenchymal components and 17.6 and 9.7 months in those with heterologous mesenchymal components, respectively. It was found that the presence of heterologous mesenchymal components significantly reduced both overall survival and disease-free survival (odds ratio [OR], 2.861; 95% confidence interval [CI] 1.196-6.841; p=0.018 and OR, 3.697; 95%CI 1.572-8.695; p=0.003, respectively). In addition, both lymphadenectomy and adjuvant radiotherapy were found to significantly increase overall survival and disease-free survival. Age was found to increase only disease-free survival. CONCLUSION: The results obtained in this study showed that the presence of heterologous components in uterine carcinosarcoma is a prognostic factor that adversely affects both overall survival and disease-free survival. Lymphadenectomy and adjuvant radiotherapy have beneficial effects on both overall survival and disease-free survival.
ABSTRACT
Trata-se de um estudo descritivo de série temporal sobre mortalidade por câncer de útero em mulheres residentes no Estado de São Paulo, segundo faixa etária e distribuição no Município de São Paulo ou demais municípios, durante o período entre 1980 e 1998. A partir de dados populacionais obtidos da Fundação IBGE, e dados de óbitos por câncer de corpo de útero e de útero (SOE) obtidos do CDROM do Ministério da Saúde sobre Sistema de Informação sobre Mortalidade, foram analisados 19 anos consecutivos, entre 1980 e 1998, levando-se em consideração as variáveis:- local de residência (Município de São Paulo ou demais municípios), idade da mulher e ano do óbito. A análise da tendência dos coeficientes foi realizada calculando-se os coeficientes brutos e padronizados de mortalidade, anualmente. A análise temporal da mortalidade por câncer de útero durante este período verificou uma tendência decrescente do coeficiente de mortalidade por câncer de útero (SOE) e uma tendência de aumento do coeficiente de mortalidade por câncer de corpo de útero no Estado de São Paulo, Município de São Paulo e demais municípios do Estado. O Estado de São Paulo e o Município apresentam perfis de países desenvolvidos, quanto às elevadas incidências de neoplasia uterina, entretanto, não se enquadram na mesma categoria quanto à consecução de medidas necessárias à prevenção, diagnóstico precoce e controle da doença, uma vez que as taxas de mortalidade também aumentam significativamente(AU)
This research project is a descriptive time-series study of the frequency of cancer of uterus in the state of São Paulo, according to age and distribution in São Paulo city and other cities of the state, during the period from 1980 to 1998. The above-mentioned tendency study, during 19 years, between 1980 and 1998, was based on information obtained from the databank of IBGE and the national Ministry of Health. Mortality rates have been analyzed according to age and distribution in So Paulo city, other cities of the state and year of death. The time-series analysis has been calculated with brutos and standard coefficients. The analysis of cancer of uterus mortality over time during this period presents an increase but the tendency of mortality due to uterine cancers not otherwise specified (NOS), shows a sharper decrease. When the results obtained are analyzed it may be concluded that both the State and City of São Paulo present priorities typical of developed countries, as concerns the high incidence of this neoplasm, they do not, however, belong to the same category as regards the access to the measures necessary as may seen from the considerable increase in the death rates from this cause.(AU)