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Tytuł pozycji:

Trends in ovarian conservation and association with survival in premenopausal patients with stage I leiomyosarcoma.

Tytuł:
Trends in ovarian conservation and association with survival in premenopausal patients with stage I leiomyosarcoma.
Autorzy:
Sia TY; Columbia University Irving Medical Center, New York, NY, United States of America.
Huang Y; Columbia University Irving Medical Center, New York, NY, United States of America.
Gockley A; Columbia University Irving Medical Center, New York, NY, United States of America; Herbert Irving Comprehensive Cancer Center, United States of America.
Melamed A; Columbia University Irving Medical Center, New York, NY, United States of America; Herbert Irving Comprehensive Cancer Center, United States of America.
Khoury-Collado F; Columbia University Irving Medical Center, New York, NY, United States of America; Herbert Irving Comprehensive Cancer Center, United States of America.
St Clair C; Columbia University Irving Medical Center, New York, NY, United States of America; Herbert Irving Comprehensive Cancer Center, United States of America.
Hou JY; Columbia University Irving Medical Center, New York, NY, United States of America; Herbert Irving Comprehensive Cancer Center, United States of America.
Tergas AI; Columbia University Irving Medical Center, New York, NY, United States of America; Herbert Irving Comprehensive Cancer Center, United States of America.
Hershman DL; Columbia University Irving Medical Center, New York, NY, United States of America; Herbert Irving Comprehensive Cancer Center, United States of America.
Wright JD; Columbia University Irving Medical Center, New York, NY, United States of America; Herbert Irving Comprehensive Cancer Center, United States of America. Electronic address: .
Źródło:
Gynecologic oncology [Gynecol Oncol] 2021 Jun; Vol. 161 (3), pp. 734-740. Date of Electronic Publication: 2021 Mar 31.
Typ publikacji:
Journal Article
Język:
English
Imprint Name(s):
Original Publication: New York, Academic Press.
MeSH Terms:
Organ Sparing Treatments*
Perimenopause*
Leiomyosarcoma/*therapy
Uterine Neoplasms/*therapy
Adult ; Databases, Factual ; Female ; Humans ; Hysterectomy ; Leiomyosarcoma/mortality ; Leiomyosarcoma/pathology ; Middle Aged ; Neoplasm Staging ; Ovariectomy ; Survival Analysis ; United States ; Uterine Neoplasms/mortality ; Uterine Neoplasms/pathology
Contributed Indexing:
Keywords: Leiomyosarcoma; Oophorectomy; Ovarian conservation
Entry Date(s):
Date Created: 20210403 Date Completed: 20220103 Latest Revision: 20220103
Update Code:
20240105
DOI:
10.1016/j.ygyno.2021.03.027
PMID:
33810881
Czasopismo naukowe
Objective: To explore trends of ovarian conservation (OCN) over time in young women with early stage leiomyosarcoma (LMS) and examine the association between OCN and survival.
Methods: Patients under the age of 50 who were diagnosed with stage I LMS who underwent hysterectomy with and without oophorectomy between 2010 and 2016 were identified in the National Cancer Database (NCDB). Performance of oophorectomy vs. OCN was determined using surgery codes. Trends of OCN were reported. Multivariable regression models were fit to estimate predictors of OCN. An inverse probability of treatment weighted propensity score method was used to examine the association between all-cause mortality and OCN.
Results: Overall, 225 patients (28%) underwent OCN. Rates of OCN decreased from 41.2% (2010) to 14.3% (2016); this finding was consistent across age groups: <35, 35-39, 40-44, and 45-49 years. Race, insurance, and stage did not affect performance of OCN. Women with poorly differentiated tumors were less likely to undergo OCN compared to well-differentiated tumors (aRR 0.59; 95% CI 0.40-0.86). After propensity score weighting, there was no association between OCN and mortality (HR 1.19, 95% CI 0.80-1.77). Five-year survival for the OCN group was 67.1% (95% CI 59.8-75.2%) compared to 72.2% for the oophorectomy group (95% CI 67.2-77.5%).
Conclusions: OCN for early stage LMS in premenopausal women has decreased over time. There was no association between OCN and mortality among women with stage I LMS. OCN should be considered in premenopausal women with stage I LMS given the health benefits.
Competing Interests: Declaration of Competing Interest Dr. Wright has served as a consultant for Clovis Oncology and received research funding from Merck. Dr. Tergas received personal fees from Immunomic Therapeutics outside the submitted work.
(Copyright © 2021. Published by Elsevier Inc.)

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