Characterizing sarcoma dominance pattern in uterine carcinosarcoma: Homologous versus heterologous element

Koji Matsuo; Yutaka Takazawa; Malcolm S Ross; Esther Elishaev; Mayu Yunokawa; Todd B Sheridan; Stephen H Bush; Merieme M Klobocista; Erin A Blake; Tadao Takano; Tsukasa Baba; Shinya Satoh; Masako Shida; Yuji Ikeda; Sosuke Adachi; Takuhei Yokoyama; Munetaka Takekuma; Shiori Yanai; Satoshi Takeuchi; Masato Nishimura; Keita Iwasaki; Marian S Johnson; Masayuki Yoshida; Ardeshir Hakam; Hiroko Machida; Paulette Mhawech-Fauceglia; Yutaka Ueda; Kiyoshi Yoshino; Hiroshi Kajiwara; Kosei Hasegawa; Masanori Yasuda; Takahito M Miyake; Takuya Moriya; Yoshiaki Yuba; Terry Morgan; Tomoyuki Fukagawa; Tanja Pejovic; Tadayoshi Nagano; Takeshi Sasaki; Abby M Richmond; Miriam D Post; Mian M K Shahzad; Dwight D Im; Hiroshi Yoshida; Kohei Omatsu; Frederick R Ueland; Joseph L Kelley; Rouzan G Karabakhtsian; Lynda D Roman

doi:10.1016/j.suronc.2018.05.017

Characterizing sarcoma dominance pattern in uterine carcinosarcoma: Homologous versus heterologous element

Koji Matsuo, Yutaka Takazawa, Malcolm S Ross, Esther Elishaev, Mayu Yunokawa, Todd B Sheridan, Stephen H Bush, Merieme M Klobocista, Erin A Blake, Tadao Takano, Tsukasa Baba, Shinya Satoh, Masako Shida, Yuji Ikeda, Sosuke Adachi, Takuhei Yokoyama, Munetaka Takekuma, Shiori Yanai, Satoshi Takeuchi, Masato NishimuraKeita Iwasaki, Marian S Johnson, Masayuki Yoshida, Ardeshir Hakam, Hiroko Machida, Paulette Mhawech-Fauceglia, Yutaka Ueda, Kiyoshi Yoshino, Hiroshi Kajiwara, Kosei Hasegawa, Masanori Yasuda, Takahito M Miyake, Takuya Moriya, Yoshiaki Yuba, Terry Morgan, Tomoyuki Fukagawa, Tanja Pejovic, Tadayoshi Nagano, Takeshi Sasaki, Abby M Richmond, Miriam D Post, Mian M K Shahzad, Dwight D Im, Hiroshi Yoshida, Kohei Omatsu, Frederick R Ueland, Joseph L Kelley, Rouzan G Karabakhtsian, Lynda D Roman

Research output: Contribution to journal › Article › peer-review

12 Citations (Scopus)

Abstract

OBJECTIVE: To examine significance of sarcoma dominance (SD) patterns in uterine carcinosarcoma (UCS).

METHODS: This is a secondary analysis of multicenter retrospective study examining women with stages I-IV UCS who underwent primary surgery. SD was defined as >50% of sarcoma component in uterine tumor. SD patterns were grouped as homologous sarcoma without SD (homo/non-dominance, n = 351), heterologous sarcoma without SD (hetero/non-dominance, n = 174), homologous sarcoma with SD (homo/dominance, n = 175), and heterologous sarcoma with SD (hetero/dominance, n = 189), and correlated to tumor characteristics and survival.

RESULTS: SD patterns were significantly associated with age, body habitus, carcinoma type, tumor size, depth of myometrial invasion, and nodal metastasis (all, P < 0.05). On univariate analysis, SD was associated with decreased progression-free survival (PFS) and cause-specific survival (CSS) in homologous cases (both, P < 0.05) but not in heterologous cases. On multivariate models, both homologous and heterologous SD patterns remained independent prognostic factors for decreased PFS (adjusted-hazard ratio [HR] ranges: homo/dominance 1.35-1.69, and hetero/dominance 1.47-1.64) and CSS (adjusted-HR ranges: 1.52-1.84 and 1.66-1.81, respectively) compared to homo/non-dominance (all, P < 0.05). Among stage I-III disease, when tumors had SD, adding radiotherapy to chemotherapy was significantly associated with improved PFS (adjusted-HR: homo/dominance 0.49, and hetero/dominance 0.45) and CSS (0.36 and 0.31, respectively) compared to chemotherapy alone (all, P < 0.05); contrary, this association was not observed with absence of SD (all, P > 0.05).

CONCLUSION: In UCS, SD impacts survival in homologous but not in heterologous type. Regardless of sarcoma types, SD was associated with decreased survival in UCS; adding radiotherapy to chemotherapy may be an effective postoperative strategy.

Original language	English
Pages (from-to)	433-440
Number of pages	8
Journal	Surgical Oncology
Volume	27
Issue number	3
DOIs	https://doi.org/10.1016/j.suronc.2018.05.017
Publication status	Published - Sept 2018
Externally published	Yes

Keywords

Adenocarcinoma, Clear Cell/pathology
Carcinosarcoma/pathology
Cystadenocarcinoma, Serous/pathology
Endometrial Neoplasms/pathology
Female
Follow-Up Studies
Humans
Male
Middle Aged
Prognosis
Retrospective Studies
Survival Rate
Uterine Neoplasms/pathology

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10.1016/j.suronc.2018.05.017

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Matsuo, K., Takazawa, Y., Ross, M. S., Elishaev, E., Yunokawa, M., Sheridan, T. B., Bush, S. H., Klobocista, M. M., Blake, E. A., Takano, T., Baba, T., Satoh, S., Shida, M., Ikeda, Y., Adachi, S., Yokoyama, T., Takekuma, M., Yanai, S., Takeuchi, S., ... Roman, L. D. (2018). Characterizing sarcoma dominance pattern in uterine carcinosarcoma: Homologous versus heterologous element. Surgical Oncology, 27(3), 433-440. https://doi.org/10.1016/j.suronc.2018.05.017

Matsuo, K, Takazawa, Y, Ross, MS, Elishaev, E, Yunokawa, M, Sheridan, TB, Bush, SH, Klobocista, MM, Blake, EA, Takano, T, Baba, T, Satoh, S, Shida, M, Ikeda, Y, Adachi, S, Yokoyama, T, Takekuma, M, Yanai, S, Takeuchi, S, Nishimura, M, Iwasaki, K, Johnson, MS, Yoshida, M, Hakam, A, Machida, H, Mhawech-Fauceglia, P, Ueda, Y, Yoshino, K, Kajiwara, H, Hasegawa, K, Yasuda, M, Miyake, TM, Moriya, T, Yuba, Y, Morgan, T, Fukagawa, T, Pejovic, T, Nagano, T, Sasaki, T, Richmond, AM, Post, MD, Shahzad, MMK, Im, DD, Yoshida, H, Omatsu, K, Ueland, FR, Kelley, JL, Karabakhtsian, RG & Roman, LD 2018, 'Characterizing sarcoma dominance pattern in uterine carcinosarcoma: Homologous versus heterologous element', Surgical Oncology, vol. 27, no. 3, pp. 433-440. https://doi.org/10.1016/j.suronc.2018.05.017

@article{430673b3be224b1f85985b1d659daf44,

title = "Characterizing sarcoma dominance pattern in uterine carcinosarcoma: Homologous versus heterologous element",

abstract = "OBJECTIVE: To examine significance of sarcoma dominance (SD) patterns in uterine carcinosarcoma (UCS).METHODS: This is a secondary analysis of multicenter retrospective study examining women with stages I-IV UCS who underwent primary surgery. SD was defined as >50% of sarcoma component in uterine tumor. SD patterns were grouped as homologous sarcoma without SD (homo/non-dominance, n = 351), heterologous sarcoma without SD (hetero/non-dominance, n = 174), homologous sarcoma with SD (homo/dominance, n = 175), and heterologous sarcoma with SD (hetero/dominance, n = 189), and correlated to tumor characteristics and survival.RESULTS: SD patterns were significantly associated with age, body habitus, carcinoma type, tumor size, depth of myometrial invasion, and nodal metastasis (all, P < 0.05). On univariate analysis, SD was associated with decreased progression-free survival (PFS) and cause-specific survival (CSS) in homologous cases (both, P < 0.05) but not in heterologous cases. On multivariate models, both homologous and heterologous SD patterns remained independent prognostic factors for decreased PFS (adjusted-hazard ratio [HR] ranges: homo/dominance 1.35-1.69, and hetero/dominance 1.47-1.64) and CSS (adjusted-HR ranges: 1.52-1.84 and 1.66-1.81, respectively) compared to homo/non-dominance (all, P < 0.05). Among stage I-III disease, when tumors had SD, adding radiotherapy to chemotherapy was significantly associated with improved PFS (adjusted-HR: homo/dominance 0.49, and hetero/dominance 0.45) and CSS (0.36 and 0.31, respectively) compared to chemotherapy alone (all, P < 0.05); contrary, this association was not observed with absence of SD (all, P > 0.05).CONCLUSION: In UCS, SD impacts survival in homologous but not in heterologous type. Regardless of sarcoma types, SD was associated with decreased survival in UCS; adding radiotherapy to chemotherapy may be an effective postoperative strategy.",

keywords = "Adenocarcinoma, Clear Cell/pathology, Carcinosarcoma/pathology, Cystadenocarcinoma, Serous/pathology, Endometrial Neoplasms/pathology, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prognosis, Retrospective Studies, Survival Rate, Uterine Neoplasms/pathology",

author = "Koji Matsuo and Yutaka Takazawa and Ross, {Malcolm S} and Esther Elishaev and Mayu Yunokawa and Sheridan, {Todd B} and Bush, {Stephen H} and Klobocista, {Merieme M} and Blake, {Erin A} and Tadao Takano and Tsukasa Baba and Shinya Satoh and Masako Shida and Yuji Ikeda and Sosuke Adachi and Takuhei Yokoyama and Munetaka Takekuma and Shiori Yanai and Satoshi Takeuchi and Masato Nishimura and Keita Iwasaki and Johnson, {Marian S} and Masayuki Yoshida and Ardeshir Hakam and Hiroko Machida and Paulette Mhawech-Fauceglia and Yutaka Ueda and Kiyoshi Yoshino and Hiroshi Kajiwara and Kosei Hasegawa and Masanori Yasuda and Miyake, {Takahito M} and Takuya Moriya and Yoshiaki Yuba and Terry Morgan and Tomoyuki Fukagawa and Tanja Pejovic and Tadayoshi Nagano and Takeshi Sasaki and Richmond, {Abby M} and Post, {Miriam D} and Shahzad, {Mian M K} and Im, {Dwight D} and Hiroshi Yoshida and Kohei Omatsu and Ueland, {Frederick R} and Kelley, {Joseph L} and Karabakhtsian, {Rouzan G} and Roman, {Lynda D}",

year = "2018",

month = sep,

doi = "10.1016/j.suronc.2018.05.017",

language = "English",

volume = "27",

pages = "433--440",

journal = "Surgical Oncology",

issn = "0960-7404",

publisher = "Elsevier BV",

number = "3",

}

TY - JOUR

T1 - Characterizing sarcoma dominance pattern in uterine carcinosarcoma

T2 - Homologous versus heterologous element

AU - Matsuo, Koji

AU - Takazawa, Yutaka

AU - Ross, Malcolm S

AU - Elishaev, Esther

AU - Yunokawa, Mayu

AU - Sheridan, Todd B

AU - Bush, Stephen H

AU - Klobocista, Merieme M

AU - Blake, Erin A

AU - Takano, Tadao

AU - Baba, Tsukasa

AU - Satoh, Shinya

AU - Shida, Masako

AU - Ikeda, Yuji

AU - Adachi, Sosuke

AU - Yokoyama, Takuhei

AU - Takekuma, Munetaka

AU - Yanai, Shiori

AU - Takeuchi, Satoshi

AU - Nishimura, Masato

AU - Iwasaki, Keita

AU - Johnson, Marian S

AU - Yoshida, Masayuki

AU - Hakam, Ardeshir

AU - Machida, Hiroko

AU - Mhawech-Fauceglia, Paulette

AU - Ueda, Yutaka

AU - Yoshino, Kiyoshi

AU - Kajiwara, Hiroshi

AU - Hasegawa, Kosei

AU - Yasuda, Masanori

AU - Miyake, Takahito M

AU - Moriya, Takuya

AU - Yuba, Yoshiaki

AU - Morgan, Terry

AU - Fukagawa, Tomoyuki

AU - Pejovic, Tanja

AU - Nagano, Tadayoshi

AU - Sasaki, Takeshi

AU - Richmond, Abby M

AU - Post, Miriam D

AU - Shahzad, Mian M K

AU - Im, Dwight D

AU - Yoshida, Hiroshi

AU - Omatsu, Kohei

AU - Ueland, Frederick R

AU - Kelley, Joseph L

AU - Karabakhtsian, Rouzan G

AU - Roman, Lynda D

PY - 2018/9

Y1 - 2018/9

N2 - OBJECTIVE: To examine significance of sarcoma dominance (SD) patterns in uterine carcinosarcoma (UCS).METHODS: This is a secondary analysis of multicenter retrospective study examining women with stages I-IV UCS who underwent primary surgery. SD was defined as >50% of sarcoma component in uterine tumor. SD patterns were grouped as homologous sarcoma without SD (homo/non-dominance, n = 351), heterologous sarcoma without SD (hetero/non-dominance, n = 174), homologous sarcoma with SD (homo/dominance, n = 175), and heterologous sarcoma with SD (hetero/dominance, n = 189), and correlated to tumor characteristics and survival.RESULTS: SD patterns were significantly associated with age, body habitus, carcinoma type, tumor size, depth of myometrial invasion, and nodal metastasis (all, P < 0.05). On univariate analysis, SD was associated with decreased progression-free survival (PFS) and cause-specific survival (CSS) in homologous cases (both, P < 0.05) but not in heterologous cases. On multivariate models, both homologous and heterologous SD patterns remained independent prognostic factors for decreased PFS (adjusted-hazard ratio [HR] ranges: homo/dominance 1.35-1.69, and hetero/dominance 1.47-1.64) and CSS (adjusted-HR ranges: 1.52-1.84 and 1.66-1.81, respectively) compared to homo/non-dominance (all, P < 0.05). Among stage I-III disease, when tumors had SD, adding radiotherapy to chemotherapy was significantly associated with improved PFS (adjusted-HR: homo/dominance 0.49, and hetero/dominance 0.45) and CSS (0.36 and 0.31, respectively) compared to chemotherapy alone (all, P < 0.05); contrary, this association was not observed with absence of SD (all, P > 0.05).CONCLUSION: In UCS, SD impacts survival in homologous but not in heterologous type. Regardless of sarcoma types, SD was associated with decreased survival in UCS; adding radiotherapy to chemotherapy may be an effective postoperative strategy.

AB - OBJECTIVE: To examine significance of sarcoma dominance (SD) patterns in uterine carcinosarcoma (UCS).METHODS: This is a secondary analysis of multicenter retrospective study examining women with stages I-IV UCS who underwent primary surgery. SD was defined as >50% of sarcoma component in uterine tumor. SD patterns were grouped as homologous sarcoma without SD (homo/non-dominance, n = 351), heterologous sarcoma without SD (hetero/non-dominance, n = 174), homologous sarcoma with SD (homo/dominance, n = 175), and heterologous sarcoma with SD (hetero/dominance, n = 189), and correlated to tumor characteristics and survival.RESULTS: SD patterns were significantly associated with age, body habitus, carcinoma type, tumor size, depth of myometrial invasion, and nodal metastasis (all, P < 0.05). On univariate analysis, SD was associated with decreased progression-free survival (PFS) and cause-specific survival (CSS) in homologous cases (both, P < 0.05) but not in heterologous cases. On multivariate models, both homologous and heterologous SD patterns remained independent prognostic factors for decreased PFS (adjusted-hazard ratio [HR] ranges: homo/dominance 1.35-1.69, and hetero/dominance 1.47-1.64) and CSS (adjusted-HR ranges: 1.52-1.84 and 1.66-1.81, respectively) compared to homo/non-dominance (all, P < 0.05). Among stage I-III disease, when tumors had SD, adding radiotherapy to chemotherapy was significantly associated with improved PFS (adjusted-HR: homo/dominance 0.49, and hetero/dominance 0.45) and CSS (0.36 and 0.31, respectively) compared to chemotherapy alone (all, P < 0.05); contrary, this association was not observed with absence of SD (all, P > 0.05).CONCLUSION: In UCS, SD impacts survival in homologous but not in heterologous type. Regardless of sarcoma types, SD was associated with decreased survival in UCS; adding radiotherapy to chemotherapy may be an effective postoperative strategy.

KW - Adenocarcinoma, Clear Cell/pathology

KW - Carcinosarcoma/pathology

KW - Cystadenocarcinoma, Serous/pathology

KW - Endometrial Neoplasms/pathology

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Male

KW - Middle Aged

KW - Prognosis

KW - Retrospective Studies

KW - Survival Rate

KW - Uterine Neoplasms/pathology

U2 - 10.1016/j.suronc.2018.05.017

DO - 10.1016/j.suronc.2018.05.017

M3 - Article

C2 - 30217299

SN - 0960-7404

VL - 27

SP - 433

EP - 440

JO - Surgical Oncology

JF - Surgical Oncology

IS - 3

ER -

Characterizing sarcoma dominance pattern in uterine carcinosarcoma: Homologous versus heterologous element

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