25f9711a4e4a74fd8288e8095f91ad5f 302175.pdf 41efc2a6c98bf031e322c804d88cf187b66b4496 302175.pdf 93fbd03c089bf87a520caa7a9ab6893e3fbd9047ad89901c34f4a737bf66abbd 302175.pdf Title: Prognostic Value of Lymph Node Ratio in Patients with Uterine Carcinosarcoma Subject: Uterine carcinosarcoma is a rare high-grade endometrial cancer. Controversy has surrounded a number of aspects in the diagnosis and management of this unique clinicopathological entity, including the efficacy of adjuvant therapy, which has been questioned. An unusual surgico-pathological parameter with prognostic significance in a number of tumour sites is the lymph node ratio (LNR). The availability of data in this respect has been scarce in the literature. The primary aim of this collaborative study was to evaluate the prognostic value of LNR in patients with uterine carcinosarcoma. LNR is a recognized lymph node metric used to stratify prognosis in a variety of malignancies. In this European multinational retrospective study, 93 women with uterine carcinosarcoma were included in the final analysis. We used t-tests and ANOVA for comparison between quantitative variables between the groups, and chi-square tests for qualitative variables. A multivariate analysis using Cox regression analysis was performed to determine potential prognostic factors, including the LNR. Patients were grouped with respect to LNR in terms of 0%, 20% > 0% and >20%. The analysis revealed LNR to be a significant predictor of progression-free survival (HR 1.69, CI (1.12–2.55), p = 0.012) and overall survival (HR 1.71, CI (1.07–2.7), p = 0.024). However, LNR did not remain a significant prognostic factor on multivariate analysis. Due to limitations of the retrospective study, a prospective large multinational study, which takes into effect the most recent changes to clinical practice, is warranted to elucidate the value of the pathophysiological metrics of the lymphatic system associated with prognosis. Keywords: uterine carcinosarcoma; lymph node ratio; prognosis Author: Rasiah Bharathan, Stephan Polterauer, Martha C. Lopez-Sanclemente, Hanna Trukhan, Andrei Pletnev, Angel G. Heredia, Maria M. Gil, Irina Bakinovskaya, Alena Dalamanava, Margarita Romeo, Dzmitry Rovski, Laura Baquedano, Luis Chiva, Richard Schwameis, Ignacio Zapardiel and on behalf of SARCUT Study Group Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Tue Jan 30 09:37:27 2024 CET ModDate: Tue Jan 30 09:43:07 2024 CET Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 12 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 677334 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- AZBFJT+VnURWPalladioL Type 1 Custom yes yes yes 10 0 XKBHER+URWPalladioL-Bold Type 1 Custom yes yes yes 16 0 KBXUXO+URWPalladioL-Roma Type 1 Custom yes yes yes 22 0 WPAIFW+URWPalladioL-Ital Type 1 Custom yes yes yes 27 0 KOSUXD+CMSY10 Type 1 Builtin yes yes yes 32 0 UIJACC+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 50 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 53 0 DKDFIL+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 86 0 DKDFIM+PalatinoLinotype CID TrueType Identity-H yes yes yes 89 0 DKDFJN+PalatinoLinotype TrueType WinAnsi yes yes no 95 0 DKDFJP+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 98 0 DKDGGL+PalatinoLinotype TrueType MacRoman yes yes no 101 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes yes 108 0 DKDFIL+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 128 0 DKDFJN+PalatinoLinotype TrueType WinAnsi yes yes no 131 0 DKDFJP+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 134 0 DKDGGL+PalatinoLinotype TrueType MacRoman yes yes no 137 0 SYVAVM+VnURWPalladioL-Italic Type 1 Custom yes yes yes 159 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2025-01-11 02:46:27 CET RepresentationInformation: 302175.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2025-01-10 14:41:29 CET Size: 677334 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 331 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Item: Title: Results Destination: section.3 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.6 Info: Title: Prognostic Value of Lymph Node Ratio in Patients with Uterine Carcinosarcoma Author: Rasiah Bharathan, Stephan Polterauer, Martha C. Lopez-Sanclemente, Hanna Trukhan, Andrei Pletnev, Angel G. Heredia, Maria M. Gil, Irina Bakinovskaya, Alena Dalamanava, Margarita Romeo, Dzmitry Rovski, Laura Baquedano, Luis Chiva, Richard Schwameis, Ignacio Zapardiel and on behalf of SARCUT Study Group Subject: Uterine carcinosarcoma is a rare high-grade endometrial cancer. Controversy has surrounded a number of aspects in the diagnosis and management of this unique clinicopathological entity, including the efficacy of adjuvant therapy, which has been questioned. An unusual surgico-pathological parameter with prognostic significance in a number of tumour sites is the lymph node ratio (LNR). The availability of data in this respect has been scarce in the literature. The primary aim of this collaborative study was to evaluate the prognostic value of LNR in patients with uterine carcinosarcoma. LNR is a recognized lymph node metric used to stratify prognosis in a variety of malignancies. In this European multinational retrospective study, 93 women with uterine carcinosarcoma were included in the final analysis. We used t-tests and ANOVA for comparison between quantitative variables between the groups, and chi-square tests for qualitative variables. A multivariate analysis using Cox regression analysis was performed to determine potential prognostic factors, including the LNR. Patients were grouped with respect to LNR in terms of 0%, 20% > 0% and >20%. The analysis revealed LNR to be a significant predictor of progression-free survival (HR 1.69, CI (1.12 2.55), p = 0.012) and overall survival (HR 1.71, CI (1.07 2.7), p = 0.024). However, LNR did not remain a significant prognostic factor on multivariate analysis. Due to limitations of the retrospective study, a prospective large multinational study, which takes into effect the most recent changes to clinical practice, is warranted to elucidate the value of the pathophysiological metrics of the lymphatic system associated with prognosis. 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