Surgical staging identifies occult metastases in over 50% of uterine-confined carcinosarcoma
Objective: To evaluate and define the proportion of clinically stage I Uterine Carcinosarcoma (UCS) patients who are upstaged to FIGO stages II-IVB following primary surgery based on final pathology. Methods: We performed a retrospective review of patients diagnosed and treated for UCS at our instit...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-04-01
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| Series: | Gynecologic Oncology Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352578925000475 |
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| author | William Vintzileos Hannah Beer David Miller Jayanthi Lea |
| author_facet | William Vintzileos Hannah Beer David Miller Jayanthi Lea |
| author_sort | William Vintzileos |
| collection | DOAJ |
| description | Objective: To evaluate and define the proportion of clinically stage I Uterine Carcinosarcoma (UCS) patients who are upstaged to FIGO stages II-IVB following primary surgery based on final pathology. Methods: We performed a retrospective review of patients diagnosed and treated for UCS at our institution from 2009 to 2023. All patients who underwent primary surgery for UCS and had clinically stage I (uterine-confined) disease were included. Uterine-confined disease was determined based on pre-operative physical exam and imaging. The primary outcome was the proportion of patients who were upstaged after surgery. Results: Ninety-eight patients underwent primary surgery with a median age of 64 years (IQR 59–68). Twenty-six patients (26.6 %) had suspected extra-uterine disease based on pre-operative evaluation and were excluded. Seventy-two patients (73.4 %) had uterine-confined disease based on pre-operative exam/imaging and underwent staging surgery. Of the 72 patients with clinical stage I disease, 39 patients (54.2 %) were ultimately diagnosed with advanced disease (FIGO Stages II-IVB), while 33 patients (45.8 %) had confirmed early-stage disease on final pathology (FIGO Stages IA or IB). Surgical staging revealed the following: 15.4 % (n = 6) were upstaged to Stage II, 5.1 % (n = 2) to Stage IIIA, 5.1 % (n = 2) to Stage IIIB, 35.9 % (n = 14) to Stage IIIC1, 12.8 % (n = 5) Stage IIIC2, and 25 % (n = 10) to Stage IVB. Conclusion: More than 50% of patients with pre-operative “uterine-confined” carcinosarcoma were upstaged on final pathology, mostly commonly to Stage III. Our findings underscore the importance of surgical staging since upstaging carries critical prognostic information and implications for adjuvant treatment planning. |
| format | Article |
| id | doaj-art-83fdeb3ecbd548fa964464df9b8c4733 |
| institution | OA Journals |
| issn | 2352-5789 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Gynecologic Oncology Reports |
| spelling | doaj-art-83fdeb3ecbd548fa964464df9b8c47332025-08-20T02:27:47ZengElsevierGynecologic Oncology Reports2352-57892025-04-015810172210.1016/j.gore.2025.101722Surgical staging identifies occult metastases in over 50% of uterine-confined carcinosarcomaWilliam Vintzileos0Hannah Beer1David Miller2Jayanthi Lea3Corresponding author at: University of Texas Southwestern Medical Center, Department of Obstetrics and Gynecology, 5323 Harry Hines Boulevard, Dallas, Texas 75390, USA.; University of Texas Southwestern Medical Center, Dallas, TX, USAUniversity of Texas Southwestern Medical Center, Dallas, TX, USAUniversity of Texas Southwestern Medical Center, Dallas, TX, USAUniversity of Texas Southwestern Medical Center, Dallas, TX, USAObjective: To evaluate and define the proportion of clinically stage I Uterine Carcinosarcoma (UCS) patients who are upstaged to FIGO stages II-IVB following primary surgery based on final pathology. Methods: We performed a retrospective review of patients diagnosed and treated for UCS at our institution from 2009 to 2023. All patients who underwent primary surgery for UCS and had clinically stage I (uterine-confined) disease were included. Uterine-confined disease was determined based on pre-operative physical exam and imaging. The primary outcome was the proportion of patients who were upstaged after surgery. Results: Ninety-eight patients underwent primary surgery with a median age of 64 years (IQR 59–68). Twenty-six patients (26.6 %) had suspected extra-uterine disease based on pre-operative evaluation and were excluded. Seventy-two patients (73.4 %) had uterine-confined disease based on pre-operative exam/imaging and underwent staging surgery. Of the 72 patients with clinical stage I disease, 39 patients (54.2 %) were ultimately diagnosed with advanced disease (FIGO Stages II-IVB), while 33 patients (45.8 %) had confirmed early-stage disease on final pathology (FIGO Stages IA or IB). Surgical staging revealed the following: 15.4 % (n = 6) were upstaged to Stage II, 5.1 % (n = 2) to Stage IIIA, 5.1 % (n = 2) to Stage IIIB, 35.9 % (n = 14) to Stage IIIC1, 12.8 % (n = 5) Stage IIIC2, and 25 % (n = 10) to Stage IVB. Conclusion: More than 50% of patients with pre-operative “uterine-confined” carcinosarcoma were upstaged on final pathology, mostly commonly to Stage III. Our findings underscore the importance of surgical staging since upstaging carries critical prognostic information and implications for adjuvant treatment planning.http://www.sciencedirect.com/science/article/pii/S2352578925000475CarcinosarcomaUterine-confinedSurgical StagingOccult metastases |
| spellingShingle | William Vintzileos Hannah Beer David Miller Jayanthi Lea Surgical staging identifies occult metastases in over 50% of uterine-confined carcinosarcoma Gynecologic Oncology Reports Carcinosarcoma Uterine-confined Surgical Staging Occult metastases |
| title | Surgical staging identifies occult metastases in over 50% of uterine-confined carcinosarcoma |
| title_full | Surgical staging identifies occult metastases in over 50% of uterine-confined carcinosarcoma |
| title_fullStr | Surgical staging identifies occult metastases in over 50% of uterine-confined carcinosarcoma |
| title_full_unstemmed | Surgical staging identifies occult metastases in over 50% of uterine-confined carcinosarcoma |
| title_short | Surgical staging identifies occult metastases in over 50% of uterine-confined carcinosarcoma |
| title_sort | surgical staging identifies occult metastases in over 50 of uterine confined carcinosarcoma |
| topic | Carcinosarcoma Uterine-confined Surgical Staging Occult metastases |
| url | http://www.sciencedirect.com/science/article/pii/S2352578925000475 |
| work_keys_str_mv | AT williamvintzileos surgicalstagingidentifiesoccultmetastasesinover50ofuterineconfinedcarcinosarcoma AT hannahbeer surgicalstagingidentifiesoccultmetastasesinover50ofuterineconfinedcarcinosarcoma AT davidmiller surgicalstagingidentifiesoccultmetastasesinover50ofuterineconfinedcarcinosarcoma AT jayanthilea surgicalstagingidentifiesoccultmetastasesinover50ofuterineconfinedcarcinosarcoma |