| Pelvic radiation improves local control after hysterectomy for uterine leiomyosarcoma: a 20-year experience. | |
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MedLine Citation:
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PMID: 19820372 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Uterine leiomyosarcoma (LMS) is associated with high rate of recurrence after surgical resection. The role of adjuvant radiation therapy in improving survival in women with uterine LMS is unclear. METHODS: All cases of LMS treated from 1985 to 2005 at 11 regional medical centers were identified. Kaplan-Meier survival curves were constructed and compared with log-rank testing. Multivariate analysis was performed to account for the potential influence of confounding factors. RESULTS: One hundred forty-seven patients with LMS were identified. The median age of diagnosis was 51 years with the stage distribution of stage I (n = 87), II (n = 9), III (n = 25), IV (n = 25), and unknown (n = 1). One hundred forty-three underwent total abdominal hysterectomy and bilateral salpingoophorectomy. Twenty-four (17%) of these patients received adjuvant pelvic irradiation, and 63 (44%) received adjuvant and/or palliative chemotherapy. With a median follow-up of 24 months (range, 1-249 months), the median survival for the entire group was 37 months. Cox proportional hazards modeling demonstrated the presence of high tumor grade and advanced stage adversely affected survival. Although the 5-year survival for patients who received adjuvant radiotherapy was significantly higher than those who did not (70% vs 35%), this survival advantage was not sustained as the curves crossed at 90-month follow-up. Pelvic recurrence rate was lower in the radiation group (18% vs 49%; P = 0.02). CONCLUSIONS: Adjuvant radiation therapy was associated with decreased pelvic failure and a modest improvement in 5-year survival, but did not impact overall survival with extended follow-up. |
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Authors:
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Ali Mahdavi; Bradley J Monk; Jennifer Ragazzo; Mark I Hunter; Scot E Lentz; Steven A Vasilev; Krishnansu S Tewari |
Publication Detail:
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Type: Evaluation Studies; Journal Article; Multicenter Study |
Journal Detail:
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Title: International journal of gynecological cancer : official journal of the International Gynecological Cancer Society Volume: 19 ISSN: 1525-1438 ISO Abbreviation: Int. J. Gynecol. Cancer Publication Date: 2009 Aug |
Date Detail:
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Created Date: 2009-10-12 Completed Date: 2009-12-29 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9111626 Medline TA: Int J Gynecol Cancer Country: United States |
Other Details:
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Languages: eng Pagination: 1080-4 Citation Subset: IM |
Affiliation:
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Division of Gynecologic Oncology, Chao Family Comprehensive Cancer Center, University of California-Irvine, 101 The City Drive, Orange, CA 92868-3298, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Cohort Studies Female Humans Hysterectomy* Leiomyosarcoma / diagnosis*, mortality, radiotherapy*, surgery Middle Aged Pelvis* / radiation effects Prognosis Radiotherapy / methods Radiotherapy, Adjuvant* Survival Analysis Uterine Neoplasms / diagnosis*, mortality, radiotherapy*, surgery |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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