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저자정보
차지혜 (연세대학교) 김영석 (울산대학교) 박원 (성균관대학교) 김학재 (서울대학교) 김주영 (국립암센터) 김진희 (계명대학교) 김주리 (단국대학교 의과대학 제일병원 방사선종양학교실) 윤원섭 (고려대학교) 김준원 (연세대학교) 김용배 (연세대학교)
저널정보
대한부인종양학회 Journal of Gynecologic Oncology Journal of Gynecologic Oncology Vol.27 No.6
발행연도
2016.1
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1 - 12 (12page)

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Objective: To investigate the role of radiotherapy (RT) in patients who underwenthysterectomy for uterine carcinosarcoma (UCS). Methods: Patients with the International Federation of Gynecology and Obstetrics stage I–IVa UCS who were treated between 1990 and 2012 were identified retrospectively in a multiinstitutionaldatabase. Of 235 identified patients, 97 (41.3%) received adjuvant RT. Twentytwopatients with a history of previous pelvic RT were analyzed separately. Survival outcomeswere assessed using the Kaplan-Meier method and Cox proportional hazards model. Results: Patients with a previous history of pelvic RT had poor survival outcomes, and 72.6%of these patients experienced locoregional recurrence; however, none received RT after adiagnosis of UCS. Univariate analyses revealed that pelvic lymphadenectomy (PLND) andpara-aortic lymph node sampling were significant factors for locoregional recurrence-freesurvival (LRRFS) and disease-free survival (DFS). Among patients without previous pelvicRT, the percentage of locoregional failure was lower for those who received adjuvant RT thanfor those who did not (28.5% vs. 17.5%, p=0.107). Multivariate analysis revealed significantcorrelations between PLND and LRRFS, distant metastasis-free survival, and DFS. Insubgroup analyses, RT significantly improved the 5-year LRRFS rate of patients who did notundergo PLND (52.7% vs. 18.7% for non-RT, p<0.001). J Gynecol Oncol. 2016 Nov;27(6):e58https://doi.org/10.3802/jgo.2016.27.e58pISSN 2005-0380·eISSN 2005-0399Original ArticleReceived: Feb 4, 2016Revised: Jun 23, 2016Accepted: Jun 27, 2016Correspondence toYong Bae KimDepartment of Radiation Oncology, YonseiCancer Center, Yonsei University College ofMedicine, 50-1 Yonsei-ro, Seodaemun-gu,Seoul 03722, Korea. E-mail: ybkim3@yuhs.acCopyright © 2016. Asian Society ofGynecologic Oncology, Korean Society ofGynecologic OncologyThis is an Open Access article distributedunder the terms of the Creative CommonsAttribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/)which permits unrestricted non-commercialuse, distribution, and reproduction in anymedium, provided the original work is properlycited. ORCIDJihye Chahttp://orcid.org/0000-0001-5926-5685Hak Jae Kimhttp://orcid.org/0000-0003-3602-2263Juree Kimhttp://orcid.org/0000-0002-3724-5293Won Sup Yoonhttp://orcid.org/0000-0002-6098-1993Jun Won Kimhttp://orcid.org/0000-0003-1358-364XYong Bae Kimhttp://orcid.org/0000-0003-4884-2330Conflict of InterestNo potential conflict of interest relevant to thisarticle was reported. Jihye Cha,1 Young Seok Kim,2 Won Park,3 Hak Jae Kim,4 Joo-Young Kim,5 Jin HeeKim,6 Juree Kim,7 Won Sup Yoon,8 Jun Won Kim,9 Yong Bae Kim101Department of Radiation Oncology, Yonsei University Wonju College of Medicine, Wonju, Korea2Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul,Korea3Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School ofMedicine, Seoul, Korea4Department of Radiation Oncology, Seoul National University Hospital, Seoul National University Collegeof Medicine, Seoul, Korea5Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea6Department of Radiation Oncology, Keimyung University Dongsan Medical Center, Keimyung UniversitySchool of Medicine, Daegu, Korea7Department of Radiation Oncology, Cheil General Hospital & Women's Healthcare Center, DankookUniversity College of Medicine, Seoul, Korea8Department of Radiation Oncology, Korea University Ansan Hospital, Korea University College of Medicine,Ansan, Korea9Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine,Seoul, Korea10Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul,KoreaClinical significance of radiotherapyin patients with primary uterinecarcinosarcoma: a multicenterretrospective study (KROG 13-08)Conclusion: Adjuvant RT decreased the risk of locoregional recurrence after hysterectomy for UCS, particularly in patients without surgical nodal staging. Given the poorer locoregional outcomes of patients previously subjected to pelvic RT, meticulous re-administration of RT might improve locoregional control while leading to less toxicity in these patients.

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참고문헌 (29)

참고문헌 신청
El-Nashar SA / 2011 / Uterine carcinosarcoma / Clin Obstet Gynecol 54:292~304 google schola Nielsen SN / 1998 / Clinicopathologic analysis of uterine malignant mixed müllerian tumors / Gynecol Oncol 34:372~378 google schola Dinh TV / 1989 / Mixed müllerian tumors of the uterus: a clinicopathologic study. O / Obstet Gynecol 74:388~392 google schola Kanthan R / 2011 / Uterine carcinosarcomas (malignant mixed mullerian tumours): a review with special emphasis on the controversies in management / Obstet Gynecol Int 2011:470795 google schola Nemani D / 2008 / Assessing the effects of lymphadenectomy and radiation therapy in patients with uterine carcinosarcoma: a SEER analysis / Gynecol Oncol 111:82~88 google schola

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