Tumor characteristics and outcome of uterine carcinosarcoma in women aged ≥80 years

Koji Matsuo, Malcolm S. Ross, Mayu Yunokawa, Marian S. Johnson, Hiroko Machida, Kohei Omatsu, Merieme M. Klobocista, Dwight D. Im, Shinya Satoh, Tsukasa Baba, Yuji Ikeda, Stephen H. Bush, Kosei Hasegawa, Erin A. Blake, Munetaka Takekuma, Masako Shida, Masato Nishimura, Sosuke Adachi, Tanja Pejovic, Satoshi TakeuchiTakuhei Yokoyama, Yutaka Ueda, Keita Iwasaki, Takahito M. Miyake, Shiori Yanai, Tadayoshi Nagano, Tadao Takano, Mian MK Shahzad, Frederick R. Ueland, Joseph L. Kelley, Lynda D. Roman

Research output: Contribution to journalArticlepeer-review


Objective: To examine clinico-pathological characteristics and outcomes of uterine carcinosarcoma (UCS) in women aged ≥80 years. Methods: This is a secondary analysis of a previous multicenter retrospective study examining 906 women with stage I–IV UCS who underwent primary hysterectomy. Patient demographics, treatment types, tumor characteristics, and survival were examined across aged ≥80 (n = 82 [9.1%]), aged 60–79, (n = 526 [58.1%]), and aged <60 (n = 298 [32.9%]). Results: Women in the aged ≥80 group were more likely to be Caucasian, undergo simple hysterectomy without lymphadenectomy, and receive no postoperative therapy (all, P < 0.05). Tumors in the aged ≥80 group were more likely to have high-grade carcinoma, heterologous sarcoma, and sarcoma dominance but less likely to have lympho-vascular space invasion (all, P < 0.05). Lymphadenectomy did not improve survival in the aged ≥80 group (P > 0.05), whereas lymphadenectomy was protective for survival in the younger groups (both, P < 0.05). Postoperative chemotherapy was associated with improved progression-free survival (PFS) in the aged ≥80 group (hazard ratio [HR] 0.44, 95% confidence interval [CI] 0.22–0.89, P = 0.021). With chemotherapy treatment, women in the aged ≥80 group had PFS similar to those in the aged 60–79 group (HR 0.97, 95%CI 0.51–1.83, P = 0.92). In contrast, without chemotherapy treatment, women in the aged ≥80 group had significantly decreased PFS compared to the aged 60–79 group (HR 1.62, 95%CI 1.09–2.40, P = 0.016). Similar associations were observed for postoperative radiotherapy. Conclusion: Nearly 10% of women with UCS are aged ≥80 that are characterized by aggressive tumor factors. Postoperative therapy but not extensive surgery may improve survival in this age group.

Original languageEnglish
Pages (from-to)25-32
Number of pages8
JournalSurgical Oncology
StatePublished - Jun 2019

Bibliographical note

Publisher Copyright:
© 2019 Elsevier Ltd


  • Adjuvant therapy
  • Elderly
  • Oldest old
  • Surgery
  • Survival
  • Uterine carcinosarcoma

ASJC Scopus subject areas

  • Surgery
  • Oncology


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