ASO Author Reflections: Spotlight on Malignant Peritoneal Cytology in Uterine Sarcoma: A Potential Avenue for Future Res
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ASO AUTHOR REFLECTIONS
ASO Author Reflections: Spotlight on Malignant Peritoneal Cytology in Uterine Sarcoma: A Potential Avenue for Future Research Shinya Matsuzaki, MD, PhD1
, and Koji Matsuo, MD, PhD1,2
1
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA; 2Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA
PAST
FUTURE
To date, only three studies \ AQ1 [ have investigated the effect of malignant peritoneal cytology (MPC) on the survival outcomes of uterine sarcoma.1 Two of these studies (n = 70) examined stages 1–4 uterine sarcomas and found that patients with MPC had a shorter survival than those with a negative peritoneal cytology.2,3 These limited studies highlight the fact that the effect of MPC on the survival outcome of uterine sarcoma has been understudied.
This study, which included the largest number of MPC cases with uterine sarcoma, showed an adverse survival effect of MPC. However, unresolved questions remain regarding this population. It is unknown whether treatments (e.g., systemic therapy) should be added or modified in case of MPC.4 Knowing the peritoneal cytology results for women with uterine sarcoma has the potential to stratify prognosis. However, the cancer-staging schema for uterine sarcoma from the International Federation of Gynecology and Obstetrics does not include peritoneal cytology.5 Future studies exploring the inclusion of peritoneal cytology in cancer-staging and evaluation of optimal treatment may be used in cases of uterine sarcoma.
PRESENT A population-based retrospective study was conducted using the National Cancer Institute’s Surveillance, Epidemiology, and End Result (SEER) Program. The study examined 1481 women with stages 1–4 uterine sarcoma from 2010 to 2016, and MPC was observed in 146 cases (9.9%). The findings showed that MPC was associated with an increased risk of all-cause mortality [hazard ratio (HR), 2.26; 95% confidence interval (CI), 1.88–2.71], especially in leiomyosarcoma (HR, 2.64; 95% CI, 1.94–3.59). In addition, MPC was associated with an increased all-cause mortality risk in early and advanced stages of disease.
Ó Society of Surgical Oncology 2020 First Received: 29 September 2020 Accepted: 4 October 2020 K. Matsuo, MD, PhD e-mail: [email protected]
ACKNOWLEDGMENT Koji Matsuo received support from the Ensign Endowment for Gynecologic Cancer Research.
DISCLOSURES Honorarium, Chugai, textbook editorial expense, Springer, and investigator meeting attendance expense, VBL therapeutics (K.M.); research funding, MSD (S.M.).
REFERENCES 1. Matsuo K, Matsuzaki S, Nusbaum DJ, Ki S, Chang EJ, Klar M, Roman LD. Significance of malignant peritoneal cytology on survival of women with uterine sarcoma. Ann Surg Oncol. 2020. h ttps://doi.org/10.1245/s10434-020-09202-1. 2. El Husseiny G, Al Bareedy N, Mourad WA, et al. Prognostic factors and treatment modalities in uterine sarcoma. Am J Clin Oncol. 2002;25:256–60. 3. Yalman D, Ozsaran Z, Baltalar
