Proposal for a Risk-Based Categorization of Uterine Carcinosarcoma

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; Takayuki Enomoto; Kohei Omatsu; Frederick R Ueland; Joseph L Kelley; Rouzan G Karabakhtsian; Lynda D Roman

doi:10.1245/s10434-018-6695-z

Proposal for a Risk-Based Categorization of Uterine Carcinosarcoma

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, Takayuki Enomoto, Kohei Omatsu, Frederick R Ueland, Joseph L Kelley, Rouzan G Karabakhtsian, Lynda D Roman

研究成果 › 査読

9 被引用数 (Scopus)

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PURPOSE: To propose a categorization model of uterine carcinosarcoma (UCS) based on tumor cell types (carcinoma and sarcoma) and sarcoma dominance.

METHODS: This secondary analysis of a prior multicenter retrospective study examined 889 cases of UCS with available histologic evaluation. Based on survival outcome, cases were clustered into three groups: low-grade carcinoma with nondominant homologous sarcoma [type A, n = 96 (10.8%)], (1) low-grade carcinoma with heterologous sarcoma or any sarcoma dominance and (2) high-grade carcinoma with nondominant homologous sarcoma [type B, n = 412 (46.3%)], and high-grade carcinoma with heterologous sarcoma or any sarcoma dominance [type C, n = 381 (42.9%)]. Tumor characteristics and outcome were examined based on the categorization.

RESULTS: Women in type C category were more likely to be older, obese, and Caucasian, whereas those in type A category were younger, less obese, Asian, and nulligravid (all P < 0.01). Type C tumors were more likely to have metastatic implants, large tumor size, lymphovascular space invasion with sarcoma cells, and higher lymph node ratio, whereas type A tumors were more likely to be early-stage disease and small (all P < 0.05). On multivariate analysis, tumor categorization was independently associated with progression-free survival (5-year rates: 70.1% for type A, 48.3% for type B, and 35.9% for type C, adjusted P < 0.01) and cause-specific survival (5-year rates: 82.8% for type A, 63.0% for type B, and 47.1% for type C, adjusted P < 0.01).

CONCLUSION: Characteristic differences in clinicopathological factors and outcomes in UCS imply that different underlying etiologies and biological behaviors may be present, supporting a new classification system.

本文言語	English
ページ（範囲）	3676-3684
ページ数	9
ジャーナル	Annals of Surgical Oncology
巻	25
号	12
DOI	https://doi.org/10.1245/s10434-018-6695-z
出版ステータス	Published - 11月 2018
外部発表	はい

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10.1245/s10434-018-6695-z

引用スタイル

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). Proposal for a Risk-Based Categorization of Uterine Carcinosarcoma. Annals of Surgical Oncology, 25(12), 3676-3684. https://doi.org/10.1245/s10434-018-6695-z

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, Enomoto, T, Omatsu, K, Ueland, FR, Kelley, JL, Karabakhtsian, RG & Roman, LD 2018, 'Proposal for a Risk-Based Categorization of Uterine Carcinosarcoma', Annals of Surgical Oncology, vol. 25, no. 12, pp. 3676-3684. https://doi.org/10.1245/s10434-018-6695-z

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title = "Proposal for a Risk-Based Categorization of Uterine Carcinosarcoma",

abstract = "PURPOSE: To propose a categorization model of uterine carcinosarcoma (UCS) based on tumor cell types (carcinoma and sarcoma) and sarcoma dominance.METHODS: This secondary analysis of a prior multicenter retrospective study examined 889 cases of UCS with available histologic evaluation. Based on survival outcome, cases were clustered into three groups: low-grade carcinoma with nondominant homologous sarcoma [type A, n = 96 (10.8%)], (1) low-grade carcinoma with heterologous sarcoma or any sarcoma dominance and (2) high-grade carcinoma with nondominant homologous sarcoma [type B, n = 412 (46.3%)], and high-grade carcinoma with heterologous sarcoma or any sarcoma dominance [type C, n = 381 (42.9%)]. Tumor characteristics and outcome were examined based on the categorization.RESULTS: Women in type C category were more likely to be older, obese, and Caucasian, whereas those in type A category were younger, less obese, Asian, and nulligravid (all P < 0.01). Type C tumors were more likely to have metastatic implants, large tumor size, lymphovascular space invasion with sarcoma cells, and higher lymph node ratio, whereas type A tumors were more likely to be early-stage disease and small (all P < 0.05). On multivariate analysis, tumor categorization was independently associated with progression-free survival (5-year rates: 70.1% for type A, 48.3% for type B, and 35.9% for type C, adjusted P < 0.01) and cause-specific survival (5-year rates: 82.8% for type A, 63.0% for type B, and 47.1% for type C, adjusted P < 0.01).CONCLUSION: Characteristic differences in clinicopathological factors and outcomes in UCS imply that different underlying etiologies and biological behaviors may be present, supporting a new classification system.",

keywords = "Carcinosarcoma/mortality, Female, Follow-Up Studies, Humans, Lymphatic Metastasis, Male, Middle Aged, Neoplasm Invasiveness, Pilot Projects, Prognosis, Retrospective Studies, Risk Factors, Survival Rate, Uterine Neoplasms/mortality",

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 Takayuki Enomoto and Kohei Omatsu and Ueland, {Frederick R} and Kelley, {Joseph L} and Karabakhtsian, {Rouzan G} and Roman, {Lynda D}",

year = "2018",

month = nov,

doi = "10.1245/s10434-018-6695-z",

language = "English",

volume = "25",

pages = "3676--3684",

journal = "Annals of Surgical Oncology",

issn = "1068-9265",

publisher = "Springer New York",

number = "12",

}

TY - JOUR

T1 - Proposal for a Risk-Based Categorization of Uterine Carcinosarcoma

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 - Enomoto, Takayuki

AU - Omatsu, Kohei

AU - Ueland, Frederick R

AU - Kelley, Joseph L

AU - Karabakhtsian, Rouzan G

AU - Roman, Lynda D

PY - 2018/11

Y1 - 2018/11

N2 - PURPOSE: To propose a categorization model of uterine carcinosarcoma (UCS) based on tumor cell types (carcinoma and sarcoma) and sarcoma dominance.METHODS: This secondary analysis of a prior multicenter retrospective study examined 889 cases of UCS with available histologic evaluation. Based on survival outcome, cases were clustered into three groups: low-grade carcinoma with nondominant homologous sarcoma [type A, n = 96 (10.8%)], (1) low-grade carcinoma with heterologous sarcoma or any sarcoma dominance and (2) high-grade carcinoma with nondominant homologous sarcoma [type B, n = 412 (46.3%)], and high-grade carcinoma with heterologous sarcoma or any sarcoma dominance [type C, n = 381 (42.9%)]. Tumor characteristics and outcome were examined based on the categorization.RESULTS: Women in type C category were more likely to be older, obese, and Caucasian, whereas those in type A category were younger, less obese, Asian, and nulligravid (all P < 0.01). Type C tumors were more likely to have metastatic implants, large tumor size, lymphovascular space invasion with sarcoma cells, and higher lymph node ratio, whereas type A tumors were more likely to be early-stage disease and small (all P < 0.05). On multivariate analysis, tumor categorization was independently associated with progression-free survival (5-year rates: 70.1% for type A, 48.3% for type B, and 35.9% for type C, adjusted P < 0.01) and cause-specific survival (5-year rates: 82.8% for type A, 63.0% for type B, and 47.1% for type C, adjusted P < 0.01).CONCLUSION: Characteristic differences in clinicopathological factors and outcomes in UCS imply that different underlying etiologies and biological behaviors may be present, supporting a new classification system.

AB - PURPOSE: To propose a categorization model of uterine carcinosarcoma (UCS) based on tumor cell types (carcinoma and sarcoma) and sarcoma dominance.METHODS: This secondary analysis of a prior multicenter retrospective study examined 889 cases of UCS with available histologic evaluation. Based on survival outcome, cases were clustered into three groups: low-grade carcinoma with nondominant homologous sarcoma [type A, n = 96 (10.8%)], (1) low-grade carcinoma with heterologous sarcoma or any sarcoma dominance and (2) high-grade carcinoma with nondominant homologous sarcoma [type B, n = 412 (46.3%)], and high-grade carcinoma with heterologous sarcoma or any sarcoma dominance [type C, n = 381 (42.9%)]. Tumor characteristics and outcome were examined based on the categorization.RESULTS: Women in type C category were more likely to be older, obese, and Caucasian, whereas those in type A category were younger, less obese, Asian, and nulligravid (all P < 0.01). Type C tumors were more likely to have metastatic implants, large tumor size, lymphovascular space invasion with sarcoma cells, and higher lymph node ratio, whereas type A tumors were more likely to be early-stage disease and small (all P < 0.05). On multivariate analysis, tumor categorization was independently associated with progression-free survival (5-year rates: 70.1% for type A, 48.3% for type B, and 35.9% for type C, adjusted P < 0.01) and cause-specific survival (5-year rates: 82.8% for type A, 63.0% for type B, and 47.1% for type C, adjusted P < 0.01).CONCLUSION: Characteristic differences in clinicopathological factors and outcomes in UCS imply that different underlying etiologies and biological behaviors may be present, supporting a new classification system.

KW - Carcinosarcoma/mortality

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Lymphatic Metastasis

KW - Male

KW - Middle Aged

KW - Neoplasm Invasiveness

KW - Pilot Projects

KW - Prognosis

KW - Retrospective Studies

KW - Risk Factors

KW - Survival Rate

KW - Uterine Neoplasms/mortality

U2 - 10.1245/s10434-018-6695-z

DO - 10.1245/s10434-018-6695-z

M3 - Article

C2 - 30105438

SN - 1068-9265

VL - 25

SP - 3676

EP - 3684

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

IS - 12

ER -

Proposal for a Risk-Based Categorization of Uterine Carcinosarcoma

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