(P009) Early-Stage Carcinosarcoma Treated With Adjuvant Radiotherapy and Chemotherapy

Publication
Article
OncologyOncology Vol 28 No 1S
Volume 28
Issue 1S

Adjuvant chemotherapy coupled with intravaginal radiotherapy (RT) seems to provide a good outcome in terms of low rate of isolated pelvic recurrence. However, given the rate of distant metastasis, further intensification of systemic therapy is still needed in this group of patients.

Neil B. Desai, MD, Marisa A. Kollmeier, MD, Vicky Makker, MD, Nadeem R. Abu-Rustum, MD, Richard R. Barakat, MD, Kaled M. Alektiar, MD; Memorial Sloan-Kettering Cancer Center

Purpose and Objectives: To report a single-institution experience using adjuvant chemoradiation for early-stage carcinosarcoma (CS) of the uterus.

Materials and Methods: We retrospectively reviewed 31 women with completely resected stage I–II CS following hysterectomy/bilateral salpingo-oophorectomy (BSO) who received adjuvant radiotherapy (RT) and chemotherapy from 2000–2010. Exclusions were lack of residual disease after diagnostic biopsy, positive washings, or prior abdominopelvic malignancy.

Results: Of the 31 patients, 24 (77%) were stage IA, 4 (13%) were IB, and 3 (10%) were stage II. Pelvic node sampling was performed in 97% of patients (median, 17 nodes), and para-aortic node sampling was performed in 81% (median, 6 nodes). None of the patients had positive pelvic cytology. The chemotherapy regimen was carboplatin/taxane in 26 patients (84%), ifosfamide-based doublet in 3 patients (10%), or carboplatin alone in 2 patients (6%). Adjuvant RT was primarily given as intravascular RT (IVRT) in 30/31 patients (97%) to a median dose of 21 Gy, and only 1 patient (3%) received pelvic RT. Median follow-up was 48 months. The 5-year actuarial rate of pelvic recurrence was 11% (95% confidence interval [CI], 0%–23%) and 11% for para-aortic recurrence (95% CI, 0%–22%). There were no vaginal recurrences, and the 5-year rate of isolated pelvic recurrence was 3.7% (95% CI, 0%–10%). The 5-year actuarial rate of peritoneal relapse was 11% (95% CI, 0%–22%) and 26% for other distant metastases (95% CI, 10%–42%). The 5-year disease-free survival (DFS) was 66% (95% CI, 50%–82%), and the 5-year overall survival (OS) was 79% (95% CI, 61%–96%).

Conclusions: Adjuvant chemotherapy coupled with intravaginal RT (given to 30/31 patients) seems to provide a good outcome in terms of low rate of isolated pelvic recurrence (3.7%). However, given the rate of distant metastasis, further intensification of systemic therapy is still needed in this group of patients.

Articles in this issue

(P113) Age and Marital Status Are Associated With Choice of Mastectomy in Patients Eligible for Breast Conservation Therapy
(P112) Single-Institution Experience With Intrabeam IORT for Treatment of Early-Stage Breast Cancer
(P110) Breast Cancer Before Age 40: Current Patterns in Clinical Presentation and Local Management
(P111) Accelerated Partial-Breast Irradiation With Multicatheter High-Dose-Rate Brachytherapy: Feasibility and Results in a Private Practice Cohort
(P115) Breast Cancer Laterality Does Not Influence Overall Survival in a Large Modern Cohort: Implications for Radiation-Related Cardiac Mortality
(P117) Anatomical Variations and Radiation Technique for Breast Cancer
(P116) Bilateral Immediate DIEP Reconstruction and Postmastectomy Radiotherapy: Experience at a Tertiary Care Institution
(P118) Metadherin Overexpression Is Associated With Improved Locoregional Control After Mastectomy
(P119) Effect of Economic Environment on Use of Postlumpectomy Radiation Therapy for Stage I Breast Cancer
(P120) Immediate Versus Delayed Reconstruction After Mastectomy in the United States Medicare Breast Cancer Patient
(P121) Trend in Age and Racial Disparities in the Receipt of Postlumpectomy Radiation Therapy for Stage I Breast Cancer: 2004–2009
(P122) Streamlining Referring Physicians Orders With ‘Reflex Testing’ Significantly Decreases Time to Resolution for Abnormal Screening Mammograms
(P123) National Trends in the Local Management of Early-Stage Paget Disease of the Breast
(P124) Effect of Inhomogeneity on Cardiac and Lung Dose in Partial-Breast Irradiation Using HDR Brachytherapy
(P125) Breast Cancer Outcomes With Anthracycline-Based Chemotherapy for Residual Disease Burden After Full-Dose Neoadjuvant Chemotherapy and Surgery Followed by Radiation Treatment

Newsletter

Stay up to date on recent advances in the multidisciplinary approach to cancer.

Recent Videos
“If you have a [patient in the] fourth or fifth line, [JNJ-5322] could be a valid drug of choice,” said Rakesh Popat, BSc, MBBS, MRCP, FRCPath, PhD.
Earlier treatment with daratumumab may be better tolerated for patients with pretreated MRD-negative multiple myeloma.
The trispecific antibody JNJ-5322 demonstrated superior efficacy vs approved agents in multiple myeloma in results shared at the 2025 EHA Congress.
Despite CD19 CAR T-cell therapy exhibiting efficacy in patients with relapsed/refractory large B-cell lymphoma, less than half achieve long-term remission.
Current findings from the phase 1/2 CaDAnCe-101 trial show no predictive factors of improved responses with BGB-16673 in patients with CLL or SLL.
The phase 3 NIVOSTOP trial evaluated an anti–PD-1 immunotherapy, nivolumab, in a patient population similar in the KEYNOTE-689 trial.
Related Content