Significance of histologic pattern of carcinoma and sarcoma components on survival outcomes of uterine carcinosarcoma

K. Matsuo, Y. Takazawa, M. S. Ross, E. Elishaev, I. Podzielinski, M. Yunokawa, T. B. Sheridan, S. H. Bush, M. M. Klobocista, E. A. Blake, T. Takano, S. Matsuzaki, T. Baba, S. Satoh, M. Shida, T. Nishikawa, Y. Ikeda, S. Adachi, T. Yokoyama, M. TakekumaK. Fujiwara, Y. Hazama, D. Kadogami, M. N. Moffitt, S. Takeuchi, M. Nishimura, K. Iwasaki, N. Ushioda, M. S. Johnson, M. Yoshida, A. Hakam, S. W. Li, A. M. Richmond, H. Machida, P. Mhawech-Fauceglia, Y. Ueda, K. Yoshino, K. Yamaguchi, T. Oishi, H. Kajiwara, K. Hasegawa, M. Yasuda, K. Kawana, K. Suda, T. M. Miyake, T. Moriya, Y. Yuba, T. Morgan, T. Fukagawa, A. Wakatsuki, T. Sugiyama, T. Pejovic, T. Nagano, K. Shimoya, M. Andoh, Y. Shiki, T. Enomoto, T. Sasaki, K. Fujiwara, M. Mikami, M. Shimada, I. Konishi, T. Kimura, M. D. Post, M. M. Shahzad, D. D. Im, H. Yoshida, K. Omatsu, F. R. Ueland, J. L. Kelley, Rouzan G. Karabakhtsian, L. D. Roman

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Background: To examine the effect of the histology of carcinoma and sarcoma components on survival outcome ofuterine carcinosarcoma.Patients and methods: A multicenter retrospective study was conducted to examine uterine carcinosarcoma casesthat underwent primary surgical staging. Archived slides were examined and histologic patterns were grouped based on carcinoma (low-grade versus high-grade) and sarcoma (homologous versus heterologous) components, correlating toclinico-pathological demographics and outcomes.Results: Among 1192 cases identified, 906 cases were evaluated for histologic patterns (carcinoma/sarcoma)with high-grade/homologous (40.8%) being the most common type followed by high-grade/heterologous (30.9%),low-grade/homologous (18.0%), and low-grade/heterologous (10.3%). On multivariate analysis, high-grade/heterologous(5-year rate, 34.0%, P = 0.024) and high-grade/homologous (45.8%, P = 0.017) but not low-grade/heterologous (50.6%,P = 0.089) were independently associated with decreased progression-free survival (PFS) compared with low-grade/homologous (60.3%). In addition, older age, residual disease at surgery, large tumor, sarcoma dominance, deep myometrialinvasion, lymphovascular space invasion, and advanced-stage disease were independently associated withdecreased PFS (all, P <0.01). Both postoperative chemotherapy (5-year rates, 48.6% versus 39.0%, P <0.001) andradiotherapy (50.1% versus 44.1%, P = 0.007) were significantly associated with improved PFS in univariate analysis.However, on multivariate analysis, only postoperative chemotherapy remained an independent predictor for improvedPFS [hazard ratio (HR) 0.34, 95% confidence interval (CI) 0.27-0.43, P <0.001]. On univariate analysis, significant treatmentbenefits for PFS were seen with ifosfamide for low-grade carcinoma (82.0% versus 49.8%, P = 0.001), platinum forhigh-grade carcinoma (46.9% versus 32.4%, P = 0.034) and homologous sarcoma (53.1% versus 38.2%, P = 0.017),and anthracycline for heterologous sarcoma (66.2% versus 39.3%, P = 0.005). Conversely, platinum, taxane, andanthracycline for low-grade carcinoma, and anthracycline for homologous sarcoma had no effect on PFS compared withnon-chemotherapy group (all, P > 0.05). On multivariate analysis, ifosfamide for low-grade/homologous (HR 0.21, 95% CI0.07-0.63, P = 0.005), platinum for high-grade/homologous (HR 0.36, 95% CI 0.22-0.60, P <0.001), and anthracyclinefor high-grade/heterologous (HR 0.30, 95% CI 0.14-0.62, P = 0.001) remained independent predictors for improvedPFS. Analyses of 1096 metastatic sites showed that carcinoma components tended to spread lymphatically, whilesarcoma components tended to spreadloco-regionally (P <0.001).Conclusion: Characterization of histologic pattern provides valuable information in the management of uterinecarcinosarcoma.

Original languageEnglish (US)
Article numbermdw161
Pages (from-to)1257-1266
Number of pages10
JournalAnnals of Oncology
Volume27
Issue number7
DOIs
StatePublished - Jul 1 2016

Fingerprint

Carcinosarcoma
Sarcoma
Carcinoma
Survival
Disease-Free Survival
Multivariate Analysis
Information Management
Ifosfamide
Platinum
Multicenter Studies
Histology
Retrospective Studies
Demography
Neoplasms

Keywords

  • Carcinoma
  • Chemotherapy
  • Histology
  • Sarcoma
  • Survival outcome
  • Uterine carcinosarcoma

ASJC Scopus subject areas

  • Oncology
  • Hematology

Cite this

Matsuo, K., Takazawa, Y., Ross, M. S., Elishaev, E., Podzielinski, I., Yunokawa, M., ... Roman, L. D. (2016). Significance of histologic pattern of carcinoma and sarcoma components on survival outcomes of uterine carcinosarcoma. Annals of Oncology, 27(7), 1257-1266. [mdw161]. https://doi.org/10.1093/annonc/mdw161

Significance of histologic pattern of carcinoma and sarcoma components on survival outcomes of uterine carcinosarcoma. / Matsuo, K.; Takazawa, Y.; Ross, M. S.; Elishaev, E.; Podzielinski, I.; Yunokawa, M.; Sheridan, T. B.; Bush, S. H.; Klobocista, M. M.; Blake, E. A.; Takano, T.; Matsuzaki, S.; Baba, T.; Satoh, S.; Shida, M.; Nishikawa, T.; Ikeda, Y.; Adachi, S.; Yokoyama, T.; Takekuma, M.; Fujiwara, K.; Hazama, Y.; Kadogami, D.; Moffitt, M. N.; Takeuchi, S.; Nishimura, M.; Iwasaki, K.; Ushioda, N.; Johnson, M. S.; Yoshida, M.; Hakam, A.; Li, S. W.; Richmond, A. M.; Machida, H.; Mhawech-Fauceglia, P.; Ueda, Y.; Yoshino, K.; Yamaguchi, K.; Oishi, T.; Kajiwara, H.; Hasegawa, K.; Yasuda, M.; Kawana, K.; Suda, K.; Miyake, T. M.; Moriya, T.; Yuba, Y.; Morgan, T.; Fukagawa, T.; Wakatsuki, A.; Sugiyama, T.; Pejovic, T.; Nagano, T.; Shimoya, K.; Andoh, M.; Shiki, Y.; Enomoto, T.; Sasaki, T.; Fujiwara, K.; Mikami, M.; Shimada, M.; Konishi, I.; Kimura, T.; Post, M. D.; Shahzad, M. M.; Im, D. D.; Yoshida, H.; Omatsu, K.; Ueland, F. R.; Kelley, J. L.; Karabakhtsian, Rouzan G.; Roman, L. D.

In: Annals of Oncology, Vol. 27, No. 7, mdw161, 01.07.2016, p. 1257-1266.

Research output: Contribution to journalArticle

Matsuo, K, Takazawa, Y, Ross, MS, Elishaev, E, Podzielinski, I, Yunokawa, M, Sheridan, TB, Bush, SH, Klobocista, MM, Blake, EA, Takano, T, Matsuzaki, S, Baba, T, Satoh, S, Shida, M, Nishikawa, T, Ikeda, Y, Adachi, S, Yokoyama, T, Takekuma, M, Fujiwara, K, Hazama, Y, Kadogami, D, Moffitt, MN, Takeuchi, S, Nishimura, M, Iwasaki, K, Ushioda, N, Johnson, MS, Yoshida, M, Hakam, A, Li, SW, Richmond, AM, Machida, H, Mhawech-Fauceglia, P, Ueda, Y, Yoshino, K, Yamaguchi, K, Oishi, T, Kajiwara, H, Hasegawa, K, Yasuda, M, Kawana, K, Suda, K, Miyake, TM, Moriya, T, Yuba, Y, Morgan, T, Fukagawa, T, Wakatsuki, A, Sugiyama, T, Pejovic, T, Nagano, T, Shimoya, K, Andoh, M, Shiki, Y, Enomoto, T, Sasaki, T, Fujiwara, K, Mikami, M, Shimada, M, Konishi, I, Kimura, T, Post, MD, Shahzad, MM, Im, DD, Yoshida, H, Omatsu, K, Ueland, FR, Kelley, JL, Karabakhtsian, RG & Roman, LD 2016, 'Significance of histologic pattern of carcinoma and sarcoma components on survival outcomes of uterine carcinosarcoma', Annals of Oncology, vol. 27, no. 7, mdw161, pp. 1257-1266. https://doi.org/10.1093/annonc/mdw161
Matsuo K, Takazawa Y, Ross MS, Elishaev E, Podzielinski I, Yunokawa M et al. Significance of histologic pattern of carcinoma and sarcoma components on survival outcomes of uterine carcinosarcoma. Annals of Oncology. 2016 Jul 1;27(7):1257-1266. mdw161. https://doi.org/10.1093/annonc/mdw161
Matsuo, K. ; Takazawa, Y. ; Ross, M. S. ; Elishaev, E. ; Podzielinski, I. ; Yunokawa, M. ; Sheridan, T. B. ; Bush, S. H. ; Klobocista, M. M. ; Blake, E. A. ; Takano, T. ; Matsuzaki, S. ; Baba, T. ; Satoh, S. ; Shida, M. ; Nishikawa, T. ; Ikeda, Y. ; Adachi, S. ; Yokoyama, T. ; Takekuma, M. ; Fujiwara, K. ; Hazama, Y. ; Kadogami, D. ; Moffitt, M. N. ; Takeuchi, S. ; Nishimura, M. ; Iwasaki, K. ; Ushioda, N. ; Johnson, M. S. ; Yoshida, M. ; Hakam, A. ; Li, S. W. ; Richmond, A. M. ; Machida, H. ; Mhawech-Fauceglia, P. ; Ueda, Y. ; Yoshino, K. ; Yamaguchi, K. ; Oishi, T. ; Kajiwara, H. ; Hasegawa, K. ; Yasuda, M. ; Kawana, K. ; Suda, K. ; Miyake, T. M. ; Moriya, T. ; Yuba, Y. ; Morgan, T. ; Fukagawa, T. ; Wakatsuki, A. ; Sugiyama, T. ; Pejovic, T. ; Nagano, T. ; Shimoya, K. ; Andoh, M. ; Shiki, Y. ; Enomoto, T. ; Sasaki, T. ; Fujiwara, K. ; Mikami, M. ; Shimada, M. ; Konishi, I. ; Kimura, T. ; Post, M. D. ; Shahzad, M. M. ; Im, D. D. ; Yoshida, H. ; Omatsu, K. ; Ueland, F. R. ; Kelley, J. L. ; Karabakhtsian, Rouzan G. ; Roman, L. D. / Significance of histologic pattern of carcinoma and sarcoma components on survival outcomes of uterine carcinosarcoma. In: Annals of Oncology. 2016 ; Vol. 27, No. 7. pp. 1257-1266.
@article{57d621a365f64c3aa1a38df189ccdff4,
title = "Significance of histologic pattern of carcinoma and sarcoma components on survival outcomes of uterine carcinosarcoma",
abstract = "Background: To examine the effect of the histology of carcinoma and sarcoma components on survival outcome ofuterine carcinosarcoma.Patients and methods: A multicenter retrospective study was conducted to examine uterine carcinosarcoma casesthat underwent primary surgical staging. Archived slides were examined and histologic patterns were grouped based on carcinoma (low-grade versus high-grade) and sarcoma (homologous versus heterologous) components, correlating toclinico-pathological demographics and outcomes.Results: Among 1192 cases identified, 906 cases were evaluated for histologic patterns (carcinoma/sarcoma)with high-grade/homologous (40.8{\%}) being the most common type followed by high-grade/heterologous (30.9{\%}),low-grade/homologous (18.0{\%}), and low-grade/heterologous (10.3{\%}). On multivariate analysis, high-grade/heterologous(5-year rate, 34.0{\%}, P = 0.024) and high-grade/homologous (45.8{\%}, P = 0.017) but not low-grade/heterologous (50.6{\%},P = 0.089) were independently associated with decreased progression-free survival (PFS) compared with low-grade/homologous (60.3{\%}). In addition, older age, residual disease at surgery, large tumor, sarcoma dominance, deep myometrialinvasion, lymphovascular space invasion, and advanced-stage disease were independently associated withdecreased PFS (all, P <0.01). Both postoperative chemotherapy (5-year rates, 48.6{\%} versus 39.0{\%}, P <0.001) andradiotherapy (50.1{\%} versus 44.1{\%}, P = 0.007) were significantly associated with improved PFS in univariate analysis.However, on multivariate analysis, only postoperative chemotherapy remained an independent predictor for improvedPFS [hazard ratio (HR) 0.34, 95{\%} confidence interval (CI) 0.27-0.43, P <0.001]. On univariate analysis, significant treatmentbenefits for PFS were seen with ifosfamide for low-grade carcinoma (82.0{\%} versus 49.8{\%}, P = 0.001), platinum forhigh-grade carcinoma (46.9{\%} versus 32.4{\%}, P = 0.034) and homologous sarcoma (53.1{\%} versus 38.2{\%}, P = 0.017),and anthracycline for heterologous sarcoma (66.2{\%} versus 39.3{\%}, P = 0.005). Conversely, platinum, taxane, andanthracycline for low-grade carcinoma, and anthracycline for homologous sarcoma had no effect on PFS compared withnon-chemotherapy group (all, P > 0.05). On multivariate analysis, ifosfamide for low-grade/homologous (HR 0.21, 95{\%} CI0.07-0.63, P = 0.005), platinum for high-grade/homologous (HR 0.36, 95{\%} CI 0.22-0.60, P <0.001), and anthracyclinefor high-grade/heterologous (HR 0.30, 95{\%} CI 0.14-0.62, P = 0.001) remained independent predictors for improvedPFS. Analyses of 1096 metastatic sites showed that carcinoma components tended to spread lymphatically, whilesarcoma components tended to spreadloco-regionally (P <0.001).Conclusion: Characterization of histologic pattern provides valuable information in the management of uterinecarcinosarcoma.",
keywords = "Carcinoma, Chemotherapy, Histology, Sarcoma, Survival outcome, Uterine carcinosarcoma",
author = "K. Matsuo and Y. Takazawa and Ross, {M. S.} and E. Elishaev and I. Podzielinski and M. Yunokawa and Sheridan, {T. B.} and Bush, {S. H.} and Klobocista, {M. M.} and Blake, {E. A.} and T. Takano and S. Matsuzaki and T. Baba and S. Satoh and M. Shida and T. Nishikawa and Y. Ikeda and S. Adachi and T. Yokoyama and M. Takekuma and K. Fujiwara and Y. Hazama and D. Kadogami and Moffitt, {M. N.} and S. Takeuchi and M. Nishimura and K. Iwasaki and N. Ushioda and Johnson, {M. S.} and M. Yoshida and A. Hakam and Li, {S. W.} and Richmond, {A. M.} and H. Machida and P. Mhawech-Fauceglia and Y. Ueda and K. Yoshino and K. Yamaguchi and T. Oishi and H. Kajiwara and K. Hasegawa and M. Yasuda and K. Kawana and K. Suda and Miyake, {T. M.} and T. Moriya and Y. Yuba and T. Morgan and T. Fukagawa and A. Wakatsuki and T. Sugiyama and T. Pejovic and T. Nagano and K. Shimoya and M. Andoh and Y. Shiki and T. Enomoto and T. Sasaki and K. Fujiwara and M. Mikami and M. Shimada and I. Konishi and T. Kimura and Post, {M. D.} and Shahzad, {M. M.} and Im, {D. D.} and H. Yoshida and K. Omatsu and Ueland, {F. R.} and Kelley, {J. L.} and Karabakhtsian, {Rouzan G.} and Roman, {L. D.}",
year = "2016",
month = "7",
day = "1",
doi = "10.1093/annonc/mdw161",
language = "English (US)",
volume = "27",
pages = "1257--1266",
journal = "Annals of Oncology",
issn = "0923-7534",
publisher = "Oxford University Press",
number = "7",

}

TY - JOUR

T1 - Significance of histologic pattern of carcinoma and sarcoma components on survival outcomes of uterine carcinosarcoma

AU - Matsuo, K.

AU - Takazawa, Y.

AU - Ross, M. S.

AU - Elishaev, E.

AU - Podzielinski, I.

AU - Yunokawa, M.

AU - Sheridan, T. B.

AU - Bush, S. H.

AU - Klobocista, M. M.

AU - Blake, E. A.

AU - Takano, T.

AU - Matsuzaki, S.

AU - Baba, T.

AU - Satoh, S.

AU - Shida, M.

AU - Nishikawa, T.

AU - Ikeda, Y.

AU - Adachi, S.

AU - Yokoyama, T.

AU - Takekuma, M.

AU - Fujiwara, K.

AU - Hazama, Y.

AU - Kadogami, D.

AU - Moffitt, M. N.

AU - Takeuchi, S.

AU - Nishimura, M.

AU - Iwasaki, K.

AU - Ushioda, N.

AU - Johnson, M. S.

AU - Yoshida, M.

AU - Hakam, A.

AU - Li, S. W.

AU - Richmond, A. M.

AU - Machida, H.

AU - Mhawech-Fauceglia, P.

AU - Ueda, Y.

AU - Yoshino, K.

AU - Yamaguchi, K.

AU - Oishi, T.

AU - Kajiwara, H.

AU - Hasegawa, K.

AU - Yasuda, M.

AU - Kawana, K.

AU - Suda, K.

AU - Miyake, T. M.

AU - Moriya, T.

AU - Yuba, Y.

AU - Morgan, T.

AU - Fukagawa, T.

AU - Wakatsuki, A.

AU - Sugiyama, T.

AU - Pejovic, T.

AU - Nagano, T.

AU - Shimoya, K.

AU - Andoh, M.

AU - Shiki, Y.

AU - Enomoto, T.

AU - Sasaki, T.

AU - Fujiwara, K.

AU - Mikami, M.

AU - Shimada, M.

AU - Konishi, I.

AU - Kimura, T.

AU - Post, M. D.

AU - Shahzad, M. M.

AU - Im, D. D.

AU - Yoshida, H.

AU - Omatsu, K.

AU - Ueland, F. R.

AU - Kelley, J. L.

AU - Karabakhtsian, Rouzan G.

AU - Roman, L. D.

PY - 2016/7/1

Y1 - 2016/7/1

N2 - Background: To examine the effect of the histology of carcinoma and sarcoma components on survival outcome ofuterine carcinosarcoma.Patients and methods: A multicenter retrospective study was conducted to examine uterine carcinosarcoma casesthat underwent primary surgical staging. Archived slides were examined and histologic patterns were grouped based on carcinoma (low-grade versus high-grade) and sarcoma (homologous versus heterologous) components, correlating toclinico-pathological demographics and outcomes.Results: Among 1192 cases identified, 906 cases were evaluated for histologic patterns (carcinoma/sarcoma)with high-grade/homologous (40.8%) being the most common type followed by high-grade/heterologous (30.9%),low-grade/homologous (18.0%), and low-grade/heterologous (10.3%). On multivariate analysis, high-grade/heterologous(5-year rate, 34.0%, P = 0.024) and high-grade/homologous (45.8%, P = 0.017) but not low-grade/heterologous (50.6%,P = 0.089) were independently associated with decreased progression-free survival (PFS) compared with low-grade/homologous (60.3%). In addition, older age, residual disease at surgery, large tumor, sarcoma dominance, deep myometrialinvasion, lymphovascular space invasion, and advanced-stage disease were independently associated withdecreased PFS (all, P <0.01). Both postoperative chemotherapy (5-year rates, 48.6% versus 39.0%, P <0.001) andradiotherapy (50.1% versus 44.1%, P = 0.007) were significantly associated with improved PFS in univariate analysis.However, on multivariate analysis, only postoperative chemotherapy remained an independent predictor for improvedPFS [hazard ratio (HR) 0.34, 95% confidence interval (CI) 0.27-0.43, P <0.001]. On univariate analysis, significant treatmentbenefits for PFS were seen with ifosfamide for low-grade carcinoma (82.0% versus 49.8%, P = 0.001), platinum forhigh-grade carcinoma (46.9% versus 32.4%, P = 0.034) and homologous sarcoma (53.1% versus 38.2%, P = 0.017),and anthracycline for heterologous sarcoma (66.2% versus 39.3%, P = 0.005). Conversely, platinum, taxane, andanthracycline for low-grade carcinoma, and anthracycline for homologous sarcoma had no effect on PFS compared withnon-chemotherapy group (all, P > 0.05). On multivariate analysis, ifosfamide for low-grade/homologous (HR 0.21, 95% CI0.07-0.63, P = 0.005), platinum for high-grade/homologous (HR 0.36, 95% CI 0.22-0.60, P <0.001), and anthracyclinefor high-grade/heterologous (HR 0.30, 95% CI 0.14-0.62, P = 0.001) remained independent predictors for improvedPFS. Analyses of 1096 metastatic sites showed that carcinoma components tended to spread lymphatically, whilesarcoma components tended to spreadloco-regionally (P <0.001).Conclusion: Characterization of histologic pattern provides valuable information in the management of uterinecarcinosarcoma.

AB - Background: To examine the effect of the histology of carcinoma and sarcoma components on survival outcome ofuterine carcinosarcoma.Patients and methods: A multicenter retrospective study was conducted to examine uterine carcinosarcoma casesthat underwent primary surgical staging. Archived slides were examined and histologic patterns were grouped based on carcinoma (low-grade versus high-grade) and sarcoma (homologous versus heterologous) components, correlating toclinico-pathological demographics and outcomes.Results: Among 1192 cases identified, 906 cases were evaluated for histologic patterns (carcinoma/sarcoma)with high-grade/homologous (40.8%) being the most common type followed by high-grade/heterologous (30.9%),low-grade/homologous (18.0%), and low-grade/heterologous (10.3%). On multivariate analysis, high-grade/heterologous(5-year rate, 34.0%, P = 0.024) and high-grade/homologous (45.8%, P = 0.017) but not low-grade/heterologous (50.6%,P = 0.089) were independently associated with decreased progression-free survival (PFS) compared with low-grade/homologous (60.3%). In addition, older age, residual disease at surgery, large tumor, sarcoma dominance, deep myometrialinvasion, lymphovascular space invasion, and advanced-stage disease were independently associated withdecreased PFS (all, P <0.01). Both postoperative chemotherapy (5-year rates, 48.6% versus 39.0%, P <0.001) andradiotherapy (50.1% versus 44.1%, P = 0.007) were significantly associated with improved PFS in univariate analysis.However, on multivariate analysis, only postoperative chemotherapy remained an independent predictor for improvedPFS [hazard ratio (HR) 0.34, 95% confidence interval (CI) 0.27-0.43, P <0.001]. On univariate analysis, significant treatmentbenefits for PFS were seen with ifosfamide for low-grade carcinoma (82.0% versus 49.8%, P = 0.001), platinum forhigh-grade carcinoma (46.9% versus 32.4%, P = 0.034) and homologous sarcoma (53.1% versus 38.2%, P = 0.017),and anthracycline for heterologous sarcoma (66.2% versus 39.3%, P = 0.005). Conversely, platinum, taxane, andanthracycline for low-grade carcinoma, and anthracycline for homologous sarcoma had no effect on PFS compared withnon-chemotherapy group (all, P > 0.05). On multivariate analysis, ifosfamide for low-grade/homologous (HR 0.21, 95% CI0.07-0.63, P = 0.005), platinum for high-grade/homologous (HR 0.36, 95% CI 0.22-0.60, P <0.001), and anthracyclinefor high-grade/heterologous (HR 0.30, 95% CI 0.14-0.62, P = 0.001) remained independent predictors for improvedPFS. Analyses of 1096 metastatic sites showed that carcinoma components tended to spread lymphatically, whilesarcoma components tended to spreadloco-regionally (P <0.001).Conclusion: Characterization of histologic pattern provides valuable information in the management of uterinecarcinosarcoma.

KW - Carcinoma

KW - Chemotherapy

KW - Histology

KW - Sarcoma

KW - Survival outcome

KW - Uterine carcinosarcoma

UR - http://www.scopus.com/inward/record.url?scp=84977083839&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84977083839&partnerID=8YFLogxK

U2 - 10.1093/annonc/mdw161

DO - 10.1093/annonc/mdw161

M3 - Article

C2 - 27052653

AN - SCOPUS:84977083839

VL - 27

SP - 1257

EP - 1266

JO - Annals of Oncology

JF - Annals of Oncology

SN - 0923-7534

IS - 7

M1 - mdw161

ER -