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• W3193741625 abstract "Objectives: Current cancer staging uses a 2-tier schema for stage I uterine leiomyosarcoma based on tumor size (≤5cm versus >5cm). Given the majority of stage I uterine leiomyosarcomas are >5cm in tumor size, this study examined the utility of a 3-tier schema (≤5cm, 5.1-10cm, and >10cm) in determining survival in stage I uterine leiomyosarcoma. Methods: This retrospective study queried the Surveillance, Epidemiology, and End Result 36 Program from 1988-2016. Surgically-treated stage I uterine leiomyosarcomas with known tumor size were examined (N=2,217). Trends, characteristics, and survival were assessed based on tumor size. Results: The most common tumor size was 5.1-10cm (45.7%) followed by >10cm (35.0%) and ≤5cm (19.4%). Tumor size-shift occurred during the study period and the number of tumor size >10cm increased from 12.9% to 44.5% whereas the number of other tumor size groups decreased (P<0.001). In weighted models, 5-year overall survival (OS) rates ranged from 49.9-71.6% in the 3-tier system and 55.2-70.6% in the 2-tier system that the absolute difference was larger in the 3-tier system (21.7% versus 15.4%). In the 3-tier system, all-cause mortality risk of tumor size >10cm versus ≤5cm reached nearly two-fold (hazard ratio 1.96, 95% confidence interval 1.78-2.16). Women with tumor size >10cm were nearly twice more likely to receive adjuvant chemotherapy versus those with <5cm (adjusted-odds ratio 1.95, 95% confidence interval 1.44-2.63); but across the three tumor size groups, neither chemotherapy nor radiotherapy improved OS. Conclusions: In the past decades, tumors of stage I uterine leiomyosarcoma have become larger. A tumor size-based 3-tier staging system may be useful to differentiate survival in stage I uterine leiomyosarcoma. Tumor size appears to be a deciding factor for adjuvant chemotherapy use but it did not improve survival. Current cancer staging uses a 2-tier schema for stage I uterine leiomyosarcoma based on tumor size (≤5cm versus >5cm). Given the majority of stage I uterine leiomyosarcomas are >5cm in tumor size, this study examined the utility of a 3-tier schema (≤5cm, 5.1-10cm, and >10cm) in determining survival in stage I uterine leiomyosarcoma. This retrospective study queried the Surveillance, Epidemiology, and End Result 36 Program from 1988-2016. Surgically-treated stage I uterine leiomyosarcomas with known tumor size were examined (N=2,217). Trends, characteristics, and survival were assessed based on tumor size. The most common tumor size was 5.1-10cm (45.7%) followed by >10cm (35.0%) and ≤5cm (19.4%). Tumor size-shift occurred during the study period and the number of tumor size >10cm increased from 12.9% to 44.5% whereas the number of other tumor size groups decreased (P<0.001). In weighted models, 5-year overall survival (OS) rates ranged from 49.9-71.6% in the 3-tier system and 55.2-70.6% in the 2-tier system that the absolute difference was larger in the 3-tier system (21.7% versus 15.4%). In the 3-tier system, all-cause mortality risk of tumor size >10cm versus ≤5cm reached nearly two-fold (hazard ratio 1.96, 95% confidence interval 1.78-2.16). Women with tumor size >10cm were nearly twice more likely to receive adjuvant chemotherapy versus those with <5cm (adjusted-odds ratio 1.95, 95% confidence interval 1.44-2.63); but across the three tumor size groups, neither chemotherapy nor radiotherapy improved OS. In the past decades, tumors of stage I uterine leiomyosarcoma have become larger. A tumor size-based 3-tier staging system may be useful to differentiate survival in stage I uterine leiomyosarcoma. Tumor size appears to be a deciding factor for adjuvant chemotherapy use but it did not improve survival." @default.
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• W3193741625 date "2021-08-01" @default.
• W3193741625 modified "2023-09-26" @default.
• W3193741625 title "Proposing the 3-tier staging system for improving prognostication in stage I uterine leiomyosarcoma" @default.
• W3193741625 doi "https://doi.org/10.1016/s0090-8258(21)01121-5" @default.
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