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Survival of Patients with Uterine Carcinosarcoma Undergoing Sentinel Lymph Node Mapping.

Abstract：

PURPOSE:This study was designed to evaluate the outcome of patients with uterine carcinosarcoma undergoing sentinel lymph node (SLN) mapping. METHODS:A prospectively maintained database was reviewed for all women with uterine cancer treated at our institution from January 1, 1998 to August 31, 2014. Patients were grouped based on whether they had undergone SLN mapping or routine lymphadenectomy at the time of staging. SLN evaluation was performed according to a standard institutional protocol that incorporates a surgical algorithm and pathologic ultrastaging. RESULTS:We identified 136 patients with uterine carcinosarcoma who had undergone lymph node evaluation; 48 had surgical staging with SLN mapping and 88 had routine lymphadenectomy consisting of pelvic and/or para-aortic lymph node dissection. Stage distribution for the SLN group included: stage I, 31 (65 %); stage II, 1 (2 %); stage III, 11 (23 %); stage IV, 5 (10 %). Stage distribution for the non-SLN group included: stage I, 48 (55 %); stage II, 4 (4 %); stage III, 19 (22 %); stage IV, 17 (19 %) (p = 0.4). Median number of lymph nodes removed was 8 and 20, respectively (p ≤ 0.001). Median number of positive nodes was similar between the groups (p = 0.2). Of the 67 patients who had a documented recurrence, 14 of 20 (70 %) in the SLN and 34 of 47 (74 %) in the non-SLN group demonstrated a distant/multifocal pattern of recurrence. There was no difference in median progression-free survival between the groups (23 vs. 23.2 months, respectively; p = 0.7). CONCLUSIONS:Progression-free survival in women with uterine carcinosarcoma undergoing SLN mapping with adjuvant therapy appears similar to that of patients treated before the incorporation of the SLN protocol. Additional prospective studies with longer follow-up are necessary to validate these early results.

journal_name

Ann Surg Oncol

journal_title

Annals of surgical oncology

authors

Schiavone MB,Zivanovic O,Zhou Q,Leitao MM Jr,Levine DA,Soslow RA,Alektiar KM,Makker V,Iasonos A,Abu-Rustum NR

doi

10.1245/s10434-015-4612-2

subject

Has Abstract

pub_date

2016-01-01 00:00:00

pages

196-202

issue

eissn

1068-9265

issn

1534-4681

pii

10.1245/s10434-015-4612-2

journal_volume

pub_type

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Survival of Patients with Uterine Carcinosarcoma Undergoing Sentinel Lymph Node Mapping.