2907 - National Cancer Database Analysis of Uterine Carcinosarcoma: An Updated Series in Locally Advanced Stage Patients
Presenter(s)
R. Zitter1, A. P. Sivananthan2, C. H. Son3, and Y. Hasan3; 1University of Chicago, Chicago, IL, 2Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL, 3Department of Radiation and Cellular Oncology, University of Chicago Medical Center, Chicago, IL
Purpose/Objective(s): We report the impact of both sequential and concurrent radiotherapy (RT) on overall survival in locally advanced uterine carcinosarcoma (UC) inclusive of patients undergoing therapy within a more contemporary time period as compared to existing large database analyses.
Materials/Methods: Data from the National Cancer Database (NCDB) was accessed for patients with cancer of Uterine Corpus diagnosed from 2004-2020. We selected for patients with carcinosarcoma FIGO stage III/IVA who received surgery. Kaplan-Meier method was used for overall survival (OS) analysis. Cox PH regression model was used for univariable (UVA) and multivariable analysis (MVA).
Results: There were 4,593 patients included in total with a median follow up of 34.6 months and median age 67.5. Of the included patients, 67% were Caucasian and 28% black. Regional nodes were involved in 57%. The majority of patients received chemotherapy only (CO) as adjuvant treatment (46%), followed by sequential chemotherapy and radiation (SCRT) (20%), radiation only (RO) (6%), and concurrent chemoradiation (CRT) (3%). The 2-year OS for those that received CO was 51.39% (95% CI 49.19%-53.54%), RO was 34.59% (95% CI 28.98-40.25%), SCRT was 67.32% (95% CI 64.17-70.26%), and CRT was 67.32% (95% CI 44.01-60.99%). UVA analysis demonstrated facility location, age, race, Hispanic ethnicity, Charlson Deyo score, pelvic nodal involvement, lymphovascular invasion, receipt of immunotherapy, and adjuvant treatment modality were significantly predictive of OS. Subsequent MVA demonstrated that only age, lymphovascular invasion, and adjuvant treatment modality were predictive of OS. When compared to chemotherapy only, the HR for risk of death was 1.5 (95% CI 1.13-2.07) for RO, 0.70 (HR 0.60-0.82) for SCRT, and 1.12 for CRT (95% CI 0.80-1.57)
Conclusion: In this contemporary large database analysis, patients with locally advanced carcinosarcoma treated with adjuvant sequential chemotherapy and radiation were associated with a survival benefit compared to chemotherapy alone.