Survival outcome of women with stage IV uterine carcinosarcoma who received neoadjuvant chemotherapy followed by surgery

Survival outcome of women with stage IV uterine carcinosarcoma who received neoadjuvant... INTRODUCTIONUterine carcinosarcoma (UCS) is a rare but aggressive type of high‐grade endometrial cancer, and represents a disease of epithelial‐mesenchymal transition with the sarcoma element arising and dedifferentiated from the carcinoma component. Aggressiveness of UCS is clinically reflected in its stage distribution of tumors: unlike low‐grade endometrial cancer where the majority of tumors present with early stage disease, nearly half of UCS cases are advanced‐stage, including more than 10% with stage IV disease.Regardless of cancer stage, the standard treatment approach for high‐grade endometrial cancer including UCS is primary surgery consisting of hysterectomy, bilateral salpingo‐oophorectomy, lymphadenectomy, and/or resection of metastatic tumor implants if present. However, while primary surgical treatment is generally preferred, patients with stage IV disease are often not suitable surgical candidates for various reasons. These include presence of extensive disease burden and distant parenchymal metastasis, poor performance status, or deconditioning, and extensive medical comorbidity. All of these factors reflect the unique characteristics of UCS; specifically, that UCS is more common in elderly women and often demonstrates wide‐spread tumor progression.Neoadjuvant chemotherapy is an alternative treatment approach for patients who are not suitable for primary surgical treatment. The role of neoadjuvant chemotherapy has been studied in various types of gynecologic malignancy http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Surgical Oncology Wiley
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Publisher
Wiley Subscription Services, Inc., A Wiley Company
Copyright
© 2018 Wiley Periodicals, Inc.
ISSN
0022-4790
eISSN
1096-9098
D.O.I.
10.1002/jso.24861
Publisher site
See Article on Publisher Site

Abstract

INTRODUCTIONUterine carcinosarcoma (UCS) is a rare but aggressive type of high‐grade endometrial cancer, and represents a disease of epithelial‐mesenchymal transition with the sarcoma element arising and dedifferentiated from the carcinoma component. Aggressiveness of UCS is clinically reflected in its stage distribution of tumors: unlike low‐grade endometrial cancer where the majority of tumors present with early stage disease, nearly half of UCS cases are advanced‐stage, including more than 10% with stage IV disease.Regardless of cancer stage, the standard treatment approach for high‐grade endometrial cancer including UCS is primary surgery consisting of hysterectomy, bilateral salpingo‐oophorectomy, lymphadenectomy, and/or resection of metastatic tumor implants if present. However, while primary surgical treatment is generally preferred, patients with stage IV disease are often not suitable surgical candidates for various reasons. These include presence of extensive disease burden and distant parenchymal metastasis, poor performance status, or deconditioning, and extensive medical comorbidity. All of these factors reflect the unique characteristics of UCS; specifically, that UCS is more common in elderly women and often demonstrates wide‐spread tumor progression.Neoadjuvant chemotherapy is an alternative treatment approach for patients who are not suitable for primary surgical treatment. The role of neoadjuvant chemotherapy has been studied in various types of gynecologic malignancy

Journal

Journal of Surgical OncologyWiley

Published: Jan 1, 2018

Keywords: ; ; ; ; ;

References

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