TY - JOUR
T1 - The value of perioperative imaging in patients with uterine sarcomas
AU - Nugent, Elizabeth K.
AU - Zighelboim, Israel
AU - Case, Ashley S.
AU - Gao, Feng
AU - Thaker, Premal H.
AU - Rader, Janet S.
AU - Mutch, David G.
AU - Massad, L. Stewart
PY - 2009/10
Y1 - 2009/10
N2 - Objective: To explore the yield and impact of perioperative imaging on management among patients undergoing surgical resection and treatment of uterine sarcomas. Methods: A retrospective chart review was done for women with histologically confirmed uterine sarcomas treated at Barnes Jewish Hospital/Washington University from 2001 to 2007. Descriptive statistics, Cox multivariate models, and Kaplan-Meier plots were used to evaluate associations and survival. Results: A total of 92 patients were identified and 55 (60%) were diagnosed with stage III-IV disease. Perioperative imaging was obtained in 84 (91%) cases, including chest X-ray in 66 (72%), computerized tomography (CT) of the abdomen and pelvis in 59 (64%), chest CT in 33 (36%), positron emission tomography (PET) in 8 (9%), and CT of the head, pelvic magnetic resonance imaging (MRI), or bone scan in a total of 2 (2.2%). Imaging identified abnormalities concerning for metastases in 30 (32%) studies. Thirty-four recurrences have been documented, and 21 (62%) of these treatment failures were extrapelvic. Multivariate analysis of this series noted that tomographic evidence of extrauterine disease predicted recurrence (p = 0.028) and incomplete surgical resection (p = 0.003, HR 6.0 95% CI 1.9-19.9) predicted disease-free survival. Imaging contributed to change in surgical and post-surgical treatment decisions in 8 (9%) patients. Conclusion: Pretreatment imaging studies change management in a minority of patients with newly diagnosed uterine sarcomas.
AB - Objective: To explore the yield and impact of perioperative imaging on management among patients undergoing surgical resection and treatment of uterine sarcomas. Methods: A retrospective chart review was done for women with histologically confirmed uterine sarcomas treated at Barnes Jewish Hospital/Washington University from 2001 to 2007. Descriptive statistics, Cox multivariate models, and Kaplan-Meier plots were used to evaluate associations and survival. Results: A total of 92 patients were identified and 55 (60%) were diagnosed with stage III-IV disease. Perioperative imaging was obtained in 84 (91%) cases, including chest X-ray in 66 (72%), computerized tomography (CT) of the abdomen and pelvis in 59 (64%), chest CT in 33 (36%), positron emission tomography (PET) in 8 (9%), and CT of the head, pelvic magnetic resonance imaging (MRI), or bone scan in a total of 2 (2.2%). Imaging identified abnormalities concerning for metastases in 30 (32%) studies. Thirty-four recurrences have been documented, and 21 (62%) of these treatment failures were extrapelvic. Multivariate analysis of this series noted that tomographic evidence of extrauterine disease predicted recurrence (p = 0.028) and incomplete surgical resection (p = 0.003, HR 6.0 95% CI 1.9-19.9) predicted disease-free survival. Imaging contributed to change in surgical and post-surgical treatment decisions in 8 (9%) patients. Conclusion: Pretreatment imaging studies change management in a minority of patients with newly diagnosed uterine sarcomas.
KW - Imaging
KW - Sarcoma
KW - Staging
KW - Uterine cancer
UR - http://www.scopus.com/inward/record.url?scp=69249221264&partnerID=8YFLogxK
U2 - 10.1016/j.ygyno.2009.06.013
DO - 10.1016/j.ygyno.2009.06.013
M3 - Article
C2 - 19577795
AN - SCOPUS:69249221264
SN - 0090-8258
VL - 115
SP - 37
EP - 40
JO - Gynecologic oncology
JF - Gynecologic oncology
IS - 1
ER -