Proposal for a Risk-Based Categorization of Uterine Carcinosarcoma

Koji Matsuo, Yutaka Takazawa, Malcolm S. Ross, Esther Elishaev, Mayu Yunokawa, Todd B. Sheridan, Stephen H. Bush, Merieme M. Klobocista, Erin A. Blake, Tadao Takano, Tsukasa Baba, Shinya Satoh, Masako Shida, Yuji Ikeda, Sosuke Adachi, Takuhei Yokoyama, Munetaka Takekuma, Shiori Yanai, Satoshi Takeuchi, Masato NishimuraKeita Iwasaki, Marian S. Johnson, Masayuki Yoshida, Ardeshir Hakam, Hiroko Machida, Paulette Mhawech-Fauceglia, Yutaka Ueda, Kiyoshi Yoshino, Hiroshi Kajiwara, Kosei Hasegawa, Masanori Yasuda, Takahito M. Miyake, Takuya Moriya, Yoshiaki Yuba, Terry Morgan, Tomoyuki Fukagawa, Tanja Pejovic, Tadayoshi Nagano, Takeshi Sasaki, Abby M. Richmond, Miriam D. Post, Mian M.K. Shahzad, Dwight D. Im, Hiroshi Yoshida, Takayuki Enomoto, Kohei Omatsu, Frederick R. Ueland, Joseph L. Kelley, Rouzan G. Karabakhtsian, Lynda D. Roman

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose: To propose a categorization model of uterine carcinosarcoma (UCS) based on tumor cell types (carcinoma and sarcoma) and sarcoma dominance. Methods: This secondary analysis of a prior multicenter retrospective study examined 889 cases of UCS with available histologic evaluation. Based on survival outcome, cases were clustered into three groups: low-grade carcinoma with nondominant homologous sarcoma [type A, n = 96 (10.8%)], (1) low-grade carcinoma with heterologous sarcoma or any sarcoma dominance and (2) high-grade carcinoma with nondominant homologous sarcoma [type B, n = 412 (46.3%)], and high-grade carcinoma with heterologous sarcoma or any sarcoma dominance [type C, n = 381 (42.9%)]. Tumor characteristics and outcome were examined based on the categorization. Results: Women in type C category were more likely to be older, obese, and Caucasian, whereas those in type A category were younger, less obese, Asian, and nulligravid (all P < 0.01). Type C tumors were more likely to have metastatic implants, large tumor size, lymphovascular space invasion with sarcoma cells, and higher lymph node ratio, whereas type A tumors were more likely to be early-stage disease and small (all P < 0.05). On multivariate analysis, tumor categorization was independently associated with progression-free survival (5-year rates: 70.1% for type A, 48.3% for type B, and 35.9% for type C, adjusted P < 0.01) and cause-specific survival (5-year rates: 82.8% for type A, 63.0% for type B, and 47.1% for type C, adjusted P < 0.01). Conclusion: Characteristic differences in clinicopathological factors and outcomes in UCS imply that different underlying etiologies and biological behaviors may be present, supporting a new classification system.

Original languageEnglish (US)
Pages (from-to)3676-3684
Number of pages9
JournalAnnals of Surgical Oncology
Volume25
Issue number12
DOIs
StatePublished - Nov 1 2018

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Carcinosarcoma
Sarcoma
Carcinoma
Neoplasms
Survival
Multicenter Studies
Disease-Free Survival
Multivariate Analysis
Retrospective Studies
Lymph Nodes

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Matsuo, K., Takazawa, Y., Ross, M. S., Elishaev, E., Yunokawa, M., Sheridan, T. B., ... Roman, L. D. (2018). Proposal for a Risk-Based Categorization of Uterine Carcinosarcoma. Annals of Surgical Oncology, 25(12), 3676-3684. https://doi.org/10.1245/s10434-018-6695-z

Proposal for a Risk-Based Categorization of Uterine Carcinosarcoma. / Matsuo, Koji; Takazawa, Yutaka; Ross, Malcolm S.; Elishaev, Esther; Yunokawa, Mayu; Sheridan, Todd B.; Bush, Stephen H.; Klobocista, Merieme M.; Blake, Erin A.; Takano, Tadao; Baba, Tsukasa; Satoh, Shinya; Shida, Masako; Ikeda, Yuji; Adachi, Sosuke; Yokoyama, Takuhei; Takekuma, Munetaka; Yanai, Shiori; Takeuchi, Satoshi; Nishimura, Masato; Iwasaki, Keita; Johnson, Marian S.; Yoshida, Masayuki; Hakam, Ardeshir; Machida, Hiroko; Mhawech-Fauceglia, Paulette; Ueda, Yutaka; Yoshino, Kiyoshi; Kajiwara, Hiroshi; Hasegawa, Kosei; Yasuda, Masanori; Miyake, Takahito M.; Moriya, Takuya; Yuba, Yoshiaki; Morgan, Terry; Fukagawa, Tomoyuki; Pejovic, Tanja; Nagano, Tadayoshi; Sasaki, Takeshi; Richmond, Abby M.; Post, Miriam D.; Shahzad, Mian M.K.; Im, Dwight D.; Yoshida, Hiroshi; Enomoto, Takayuki; Omatsu, Kohei; Ueland, Frederick R.; Kelley, Joseph L.; Karabakhtsian, Rouzan G.; Roman, Lynda D.

In: Annals of Surgical Oncology, Vol. 25, No. 12, 01.11.2018, p. 3676-3684.

Research output: Contribution to journalArticle

Matsuo, K, Takazawa, Y, Ross, MS, Elishaev, E, Yunokawa, M, Sheridan, TB, Bush, SH, Klobocista, MM, Blake, EA, Takano, T, Baba, T, Satoh, S, Shida, M, Ikeda, Y, Adachi, S, Yokoyama, T, Takekuma, M, Yanai, S, Takeuchi, S, Nishimura, M, Iwasaki, K, Johnson, MS, Yoshida, M, Hakam, A, Machida, H, Mhawech-Fauceglia, P, Ueda, Y, Yoshino, K, Kajiwara, H, Hasegawa, K, Yasuda, M, Miyake, TM, Moriya, T, Yuba, Y, Morgan, T, Fukagawa, T, Pejovic, T, Nagano, T, Sasaki, T, Richmond, AM, Post, MD, Shahzad, MMK, Im, DD, Yoshida, H, Enomoto, T, Omatsu, K, Ueland, FR, Kelley, JL, Karabakhtsian, RG & Roman, LD 2018, 'Proposal for a Risk-Based Categorization of Uterine Carcinosarcoma', Annals of Surgical Oncology, vol. 25, no. 12, pp. 3676-3684. https://doi.org/10.1245/s10434-018-6695-z
Matsuo K, Takazawa Y, Ross MS, Elishaev E, Yunokawa M, Sheridan TB et al. Proposal for a Risk-Based Categorization of Uterine Carcinosarcoma. Annals of Surgical Oncology. 2018 Nov 1;25(12):3676-3684. https://doi.org/10.1245/s10434-018-6695-z
Matsuo, Koji ; Takazawa, Yutaka ; Ross, Malcolm S. ; Elishaev, Esther ; Yunokawa, Mayu ; Sheridan, Todd B. ; Bush, Stephen H. ; Klobocista, Merieme M. ; Blake, Erin A. ; Takano, Tadao ; Baba, Tsukasa ; Satoh, Shinya ; Shida, Masako ; Ikeda, Yuji ; Adachi, Sosuke ; Yokoyama, Takuhei ; Takekuma, Munetaka ; Yanai, Shiori ; Takeuchi, Satoshi ; Nishimura, Masato ; Iwasaki, Keita ; Johnson, Marian S. ; Yoshida, Masayuki ; Hakam, Ardeshir ; Machida, Hiroko ; Mhawech-Fauceglia, Paulette ; Ueda, Yutaka ; Yoshino, Kiyoshi ; Kajiwara, Hiroshi ; Hasegawa, Kosei ; Yasuda, Masanori ; Miyake, Takahito M. ; Moriya, Takuya ; Yuba, Yoshiaki ; Morgan, Terry ; Fukagawa, Tomoyuki ; Pejovic, Tanja ; Nagano, Tadayoshi ; Sasaki, Takeshi ; Richmond, Abby M. ; Post, Miriam D. ; Shahzad, Mian M.K. ; Im, Dwight D. ; Yoshida, Hiroshi ; Enomoto, Takayuki ; Omatsu, Kohei ; Ueland, Frederick R. ; Kelley, Joseph L. ; Karabakhtsian, Rouzan G. ; Roman, Lynda D. / Proposal for a Risk-Based Categorization of Uterine Carcinosarcoma. In: Annals of Surgical Oncology. 2018 ; Vol. 25, No. 12. pp. 3676-3684.
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title = "Proposal for a Risk-Based Categorization of Uterine Carcinosarcoma",
abstract = "Purpose: To propose a categorization model of uterine carcinosarcoma (UCS) based on tumor cell types (carcinoma and sarcoma) and sarcoma dominance. Methods: This secondary analysis of a prior multicenter retrospective study examined 889 cases of UCS with available histologic evaluation. Based on survival outcome, cases were clustered into three groups: low-grade carcinoma with nondominant homologous sarcoma [type A, n = 96 (10.8{\%})], (1) low-grade carcinoma with heterologous sarcoma or any sarcoma dominance and (2) high-grade carcinoma with nondominant homologous sarcoma [type B, n = 412 (46.3{\%})], and high-grade carcinoma with heterologous sarcoma or any sarcoma dominance [type C, n = 381 (42.9{\%})]. Tumor characteristics and outcome were examined based on the categorization. Results: Women in type C category were more likely to be older, obese, and Caucasian, whereas those in type A category were younger, less obese, Asian, and nulligravid (all P < 0.01). Type C tumors were more likely to have metastatic implants, large tumor size, lymphovascular space invasion with sarcoma cells, and higher lymph node ratio, whereas type A tumors were more likely to be early-stage disease and small (all P < 0.05). On multivariate analysis, tumor categorization was independently associated with progression-free survival (5-year rates: 70.1{\%} for type A, 48.3{\%} for type B, and 35.9{\%} for type C, adjusted P < 0.01) and cause-specific survival (5-year rates: 82.8{\%} for type A, 63.0{\%} for type B, and 47.1{\%} for type C, adjusted P < 0.01). Conclusion: Characteristic differences in clinicopathological factors and outcomes in UCS imply that different underlying etiologies and biological behaviors may be present, supporting a new classification system.",
author = "Koji Matsuo and Yutaka Takazawa and Ross, {Malcolm S.} and Esther Elishaev and Mayu Yunokawa and Sheridan, {Todd B.} and Bush, {Stephen H.} and Klobocista, {Merieme M.} and Blake, {Erin A.} and Tadao Takano and Tsukasa Baba and Shinya Satoh and Masako Shida and Yuji Ikeda and Sosuke Adachi and Takuhei Yokoyama and Munetaka Takekuma and Shiori Yanai and Satoshi Takeuchi and Masato Nishimura and Keita Iwasaki and Johnson, {Marian S.} and Masayuki Yoshida and Ardeshir Hakam and Hiroko Machida and Paulette Mhawech-Fauceglia and Yutaka Ueda and Kiyoshi Yoshino and Hiroshi Kajiwara and Kosei Hasegawa and Masanori Yasuda and Miyake, {Takahito M.} and Takuya Moriya and Yoshiaki Yuba and Terry Morgan and Tomoyuki Fukagawa and Tanja Pejovic and Tadayoshi Nagano and Takeshi Sasaki and Richmond, {Abby M.} and Post, {Miriam D.} and Shahzad, {Mian M.K.} and Im, {Dwight D.} and Hiroshi Yoshida and Takayuki Enomoto and Kohei Omatsu and Ueland, {Frederick R.} and Kelley, {Joseph L.} and Karabakhtsian, {Rouzan G.} and Roman, {Lynda D.}",
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TY - JOUR

T1 - Proposal for a Risk-Based Categorization of Uterine Carcinosarcoma

AU - Matsuo, Koji

AU - Takazawa, Yutaka

AU - Ross, Malcolm S.

AU - Elishaev, Esther

AU - Yunokawa, Mayu

AU - Sheridan, Todd B.

AU - Bush, Stephen H.

AU - Klobocista, Merieme M.

AU - Blake, Erin A.

AU - Takano, Tadao

AU - Baba, Tsukasa

AU - Satoh, Shinya

AU - Shida, Masako

AU - Ikeda, Yuji

AU - Adachi, Sosuke

AU - Yokoyama, Takuhei

AU - Takekuma, Munetaka

AU - Yanai, Shiori

AU - Takeuchi, Satoshi

AU - Nishimura, Masato

AU - Iwasaki, Keita

AU - Johnson, Marian S.

AU - Yoshida, Masayuki

AU - Hakam, Ardeshir

AU - Machida, Hiroko

AU - Mhawech-Fauceglia, Paulette

AU - Ueda, Yutaka

AU - Yoshino, Kiyoshi

AU - Kajiwara, Hiroshi

AU - Hasegawa, Kosei

AU - Yasuda, Masanori

AU - Miyake, Takahito M.

AU - Moriya, Takuya

AU - Yuba, Yoshiaki

AU - Morgan, Terry

AU - Fukagawa, Tomoyuki

AU - Pejovic, Tanja

AU - Nagano, Tadayoshi

AU - Sasaki, Takeshi

AU - Richmond, Abby M.

AU - Post, Miriam D.

AU - Shahzad, Mian M.K.

AU - Im, Dwight D.

AU - Yoshida, Hiroshi

AU - Enomoto, Takayuki

AU - Omatsu, Kohei

AU - Ueland, Frederick R.

AU - Kelley, Joseph L.

AU - Karabakhtsian, Rouzan G.

AU - Roman, Lynda D.

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Purpose: To propose a categorization model of uterine carcinosarcoma (UCS) based on tumor cell types (carcinoma and sarcoma) and sarcoma dominance. Methods: This secondary analysis of a prior multicenter retrospective study examined 889 cases of UCS with available histologic evaluation. Based on survival outcome, cases were clustered into three groups: low-grade carcinoma with nondominant homologous sarcoma [type A, n = 96 (10.8%)], (1) low-grade carcinoma with heterologous sarcoma or any sarcoma dominance and (2) high-grade carcinoma with nondominant homologous sarcoma [type B, n = 412 (46.3%)], and high-grade carcinoma with heterologous sarcoma or any sarcoma dominance [type C, n = 381 (42.9%)]. Tumor characteristics and outcome were examined based on the categorization. Results: Women in type C category were more likely to be older, obese, and Caucasian, whereas those in type A category were younger, less obese, Asian, and nulligravid (all P < 0.01). Type C tumors were more likely to have metastatic implants, large tumor size, lymphovascular space invasion with sarcoma cells, and higher lymph node ratio, whereas type A tumors were more likely to be early-stage disease and small (all P < 0.05). On multivariate analysis, tumor categorization was independently associated with progression-free survival (5-year rates: 70.1% for type A, 48.3% for type B, and 35.9% for type C, adjusted P < 0.01) and cause-specific survival (5-year rates: 82.8% for type A, 63.0% for type B, and 47.1% for type C, adjusted P < 0.01). Conclusion: Characteristic differences in clinicopathological factors and outcomes in UCS imply that different underlying etiologies and biological behaviors may be present, supporting a new classification system.

AB - Purpose: To propose a categorization model of uterine carcinosarcoma (UCS) based on tumor cell types (carcinoma and sarcoma) and sarcoma dominance. Methods: This secondary analysis of a prior multicenter retrospective study examined 889 cases of UCS with available histologic evaluation. Based on survival outcome, cases were clustered into three groups: low-grade carcinoma with nondominant homologous sarcoma [type A, n = 96 (10.8%)], (1) low-grade carcinoma with heterologous sarcoma or any sarcoma dominance and (2) high-grade carcinoma with nondominant homologous sarcoma [type B, n = 412 (46.3%)], and high-grade carcinoma with heterologous sarcoma or any sarcoma dominance [type C, n = 381 (42.9%)]. Tumor characteristics and outcome were examined based on the categorization. Results: Women in type C category were more likely to be older, obese, and Caucasian, whereas those in type A category were younger, less obese, Asian, and nulligravid (all P < 0.01). Type C tumors were more likely to have metastatic implants, large tumor size, lymphovascular space invasion with sarcoma cells, and higher lymph node ratio, whereas type A tumors were more likely to be early-stage disease and small (all P < 0.05). On multivariate analysis, tumor categorization was independently associated with progression-free survival (5-year rates: 70.1% for type A, 48.3% for type B, and 35.9% for type C, adjusted P < 0.01) and cause-specific survival (5-year rates: 82.8% for type A, 63.0% for type B, and 47.1% for type C, adjusted P < 0.01). Conclusion: Characteristic differences in clinicopathological factors and outcomes in UCS imply that different underlying etiologies and biological behaviors may be present, supporting a new classification system.

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