Optimal Cytoreduction is an Independent Prognostic Factor in Ovarian Carcinosarcoma: A Turkish Gynecologic Oncology Group Study
Received Date : 23 Dec 2019
Accepted Date : 29 Mar 2020
Available Online : 24 Jun 2020
Ali AYHANa, İrfan ÇİÇİNb, Ali GÖKYERb, Mustafa Erkan SARIc, Ahmet Taner TURANd, Salih TAŞKINe, Kemal GÜNGÖRDÜKf, Özgür AKBAYIRg, Pınar SAİPh, Hanifi ŞAHİNc, Gonca ÇOBANa, Samet TOPUZi, İlker SELÇUKc, Gökhan TULUNAYg, Mehmet Mutlu MEYDANLIc
aBaşkent University Faculty of Medicine, Division of Gynecologic Oncology, Ankara, TURKEY
bTrakya University Faculty of Medicine, Department of Medical Oncology, Edirne, TURKEY
cUniversity of Health Sciences, Zekai Tahir Burak Women’s Health Training and Research Hospital, Department of Gynecologic Oncology, Ankara, TURKEY
dUniversity of Health Sciences, Etlik Zübeyde Hanim Women’s Health Training and Research Hospital, Department of Gynecologic Oncology, Ankara, TURKEY
eAnkara University Faculty of Medicine, Division of Gynecologic Oncology, Ankara, TURKEY
fUniversity of Health Sciences Tepecik Education and Research Hospital, Department of Gynecologic Oncology, İzmir, TURKEY
gUniversity of Health Sciences Kanuni Sultan Süleyman Training and Research Hospital, Department of Gynecologic Oncology, İstanbul, TURKEY
hİstanbul University İstanbul Faculty of Medicine, Department of Medical Oncology, İstanbul, TURKEY
iIstanbul University İstanbul Faculty of Medicine, Division of Gynecologic Oncology, İstanbul, TURKEY
Doi: 10.37047/jos.2019-73073 - Article's Language: EN
J Oncol Sci.2020;6(2):78-86
ABSTRACT
Objective: To determine prognostic factors for women with ovarian carcinosarcoma (OCS). Material and Methods: A multicenter,
retrospective department database review was performed to identify patients with OCS at eight gynecologic oncology centers in
Turkey. Demographic, clinicopathological, and survival data were collected. Results: We identified 94 patients with OCS. The median age
was 60.0 years (range, 31-78), and the median follow-up duration was 36.0 months (range, 4-188). After primary cytoreductive surgery, 61
(64.9%) patients had ≤1 cm of residual disease (optimal debulking), whereas 33 (35.1%) had >1 cm of residual disease (suboptimal debulking).
For the entire cohort, the 5-year progression free survival (PFS) rate was 25.2%, whereas the 5-year overall survival (OS) rate was
49.4%. Women with optimal cytoreduction had a median PFS of 41.0 months (95% Confidence Interval [CI]: 19.71-62.28, Standard Error [SE]:
10.86) compared with women with suboptimal cytoreduction who had a median PFS of 15.0 months (95% CI: 8.79-21.21, SE: 3.16; p=0.011).
The 5 year OS rate for women with optimal cytoreduction was significantly higher than that of women with suboptimal debulking (57.6% vs.
33.9%; p=0.005). Positive peritoneal cytology (hazard ratio [H]: 2.35, 95% CI: 1.19-4.63; p=0.013) and suboptimal cytoreduction (H: 2.61,
95% CI: 1.32-4.99; p=0.004) were independent risk factors for decreased OS. Conclusion: Suboptimal cytoreduction seems to be an independent
prognostic factor for decreased OS in women with OCS.
Keywords: Cytoreductive surgery; ovarian carcinosarcoma; overall survival