The role of radiation in improving survival for early-stage carcinosarcoma and leiomyosarcoma

Am J Obstet Gynecol. 2008 Nov;199(5):536.e1-8. doi: 10.1016/j.ajog.2008.04.019. Epub 2008 Jun 3.


Objective: We examined the effect of radiation on survival for early-stage uterine carcinosarcomas and leiomyosarcomas.

Study design: The surveillance, epidemiology, and end results database was used to identify patients with stage I/II carcinosarcomas and leiomyosarcomas. Logistic regression and Cox models were developed to determine radiation use and survival.

Results: Among 1819 women with carcinosarcomas and 1088 women with leiomyosarcomas, radiation was administered to 667 of the patients (37%) with carcinosarcomas and to 235 of the patients (22%) with leiomyosarcomas. In a multivariate model, adjuvant radiation reduced the risk of death by 21% in women with carcinosarcomas (hazard ratio, 0.79; 95% CI, 0.7-0.9). Radiation reduced mortality rates in patients with carcinosarcomas who had not undergone node dissection but had only a marginal effect on survival in node-negative women. Adjuvant radiation had no effect on survival for early-stage leiomyosarcomas (hazard ratio, 1.1; 95% CI, 0.9-1.4).

Conclusion: Adjuvant radiotherapy improves survival for select patients with early-stage carcinosarcomas but is of limited value for leiomyosarcomas.

MeSH terms

  • Adult
  • Aged
  • Carcinosarcoma / mortality*
  • Carcinosarcoma / radiotherapy*
  • Female
  • Humans
  • Leiomyosarcoma / mortality*
  • Leiomyosarcoma / radiotherapy*
  • Logistic Models
  • Lymph Node Excision
  • Middle Aged
  • Proportional Hazards Models
  • Radiotherapy, Adjuvant
  • Uterine Neoplasms / mortality*
  • Uterine Neoplasms / radiotherapy*