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Tumor characteristics and survival outcomes of women with tamoxifen-related uterine carcinosarcoma.

Abstract：

OBJECTIVE:To examine tumor characteristics and survival outcome of women with uterine carcinosarcoma who had a history of tamoxifen use. METHODS:This is a multicenter retrospective study examining stage I-IV uterine carcinosarcoma cases based on history of tamoxifen use. Patient demographics, tumor characteristics, treatment pattern, and survival outcomes were compared between tamoxifen users and non-users. RESULTS:Sixty-six cases of tamoxifen-related uterine carcinosarcoma were compared to 1009 cases with no history of tamoxifen use. Tamoxifen users were more likely to be older (mean age, 69 versus 64, P<0.001) and had a past history of malignancy (100% versus 12.7%, P<0.001). Tamoxifen-related uterine carcinosarcoma was significantly associated with a higher proportion of stage IA disease (48.4% versus 29.9%) and a lower risk of stage IVB disease (7.8% versus 16.0%) compared to tamoxifen-unrelated carcinosarcoma (P=0.034). Deep myometrial tumor invasion was less common in uterine carcinosarcoma related to tamoxifen use (28.3% versus 48.8%, P=0.002). On univariate analysis, tamoxifen use was not associated with progression-free survival (5-year rates 44.5% versus 46.8%, P=0.48) and disease-specific survival (64.0% versus 59.1%, P=0.39). After adjusting for age, past history of malignancy, stage, residual disease status at surgery, and postoperative treatment patterns, tamoxifen use was not associated with progression-free survival (adjusted-hazard ratio 0.86, 95% confidence interval 0.50 to 1.50, P=0.60) and disease-specific survival (adjusted-hazard ratio 0.68, 95% confidence interval 0.36 to 1.29, P=0.24). CONCLUSION:Our study suggests that tamoxifen-related uterine carcinosarcoma may have favorable tumor characteristics but have comparable stage-specific survival outcomes compared to tamoxifen-unrelated uterine carcinosarcoma.

journal_name

Gynecol Oncol

journal_title

Gynecologic oncology

authors

Matsuo K,Ross MS,Bush SH,Yunokawa M,Blake EA,Takano T,Ueda Y,Baba T,Satoh S,Shida M,Ikeda Y,Adachi S,Yokoyama T,Takekuma M,Takeuchi S,Nishimura M,Iwasaki K,Yanai S,Klobocista MM,Johnson MS,Machida H,Hasegawa K,

doi

10.1016/j.ygyno.2016.11.042

subject

Has Abstract

pub_date

2017-02-01 00:00:00

pages

329-335

issue

eissn

0090-8258

issn

1095-6859

pii

S0090-8258(16)31611-0

journal_volume

144

pub_type

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Tumor characteristics and survival outcomes of women with tamoxifen-related uterine carcinosarcoma.