Universität zu Köln

Vordermark, Dirk, Medenwald, Daniel ORCID: 0000-0001-8920-2853, Izaguirre, Victor, Sieker, Frank and Marnitz, Simone (2020). The Role of Postoperative Radiotherapy for Carcinosarcoma of the Uterus. Cancers, 12 (12). BASEL: MDPI. ISSN 2072-6694

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Abstract

Simple Summary The role of radiotherapy on carcinosarcoma, a rare malignant tumor, of the uterus is unclear. We reviewed data published from 2010 on the effects of radiotherapy on tumor control and survival in this patient group. Available data were mainly from cancer registries and suggested that radiotherapy, given either as vaginal brachytherapy (contact radiotherapy of the vagina) or external-beam radiotherapy or a combination of both, reduces the risk of recurrence and improves survival in patients with all stages of carcinosarcoma of the uterus without metastases in other organs. The role of postoperative radiotherapy delivered as external-beam radiotherapy (EBRT), vaginal brachytherapy (VBT) or a combination of both, in the management of carcinosarcoma of the uterus is not clearly defined, as only limited randomized trial data are available, indicating a reduction in locoregional recurrences after EBRT. We performed a structured review of data published from 2010. Although no relevant new data from prospective trials or meta-analyses were identified, 14 analyses of cancer registry data from the United States or Europe, focusing predominantly on the endpoint for overall survival, were identified, four of them using propensity-score matching to compare subgroups treated with vs. without radiotherapy. Although stage-by-stage data are rare, the registry analyses support the idea of a beneficial effect, especially of VBT, on overall survival in International Federation of Gynecology and Obstetrics (FIGO) stage IA patients (to a lesser extent in stage IB). For stages II to III, the data sets indicate the largest effects on overall survival for the combination of EBRT and VBT. In all stages, survival effects of radiotherapy apparently persist when given in addition to chemotherapy. Whereas some studies see the strongest survival effects in patients with positive lymph nodes, propensity-score matched data indicate an overall survival effect of radiotherapy (EBRT + VBT or VBT alone) in FIGO stages I to III regardless of lymph node surgery.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Vordermark, Dirk UNSPECIFIED UNSPECIFIED UNSPECIFIED Medenwald, Daniel UNSPECIFIED orcid.org/0000-0001-8920-2853 UNSPECIFIED Izaguirre, Victor UNSPECIFIED UNSPECIFIED UNSPECIFIED Sieker, Frank UNSPECIFIED UNSPECIFIED UNSPECIFIED Marnitz, Simone UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-309345
DOI:	10.3390/cancers12123573
Journal or Publication Title:	Cancers
Volume:	12
Number:	12
Date:	2020
Publisher:	MDPI
Place of Publication:	BASEL
ISSN:	2072-6694
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ADJUVANT RADIATION-THERAPY; UTERINE CARCINOSARCOMA; STAGE-I; CANCER; IMPACT; LYMPHADENECTOMY; CHEMOTHERAPY; IFOSFAMIDE; SURVIVAL; TRIAL Multiple languages Oncology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/30934