Postoperative pelvic irradiation in early stage uterine mixed mullerian tumors

Purpose of investigation: To review our management experience with uterine mixed mullerian tumors (MMTs) in order to evaluate potential prognostic ind icators, and assess the efficacy of various treatment modalities. Methods: A retrospective, clinicopathologic evaluation of 43 patients prese nting for treatment of uterine MMTs between 1982 and 1992 was conducted. Di agnostic criteria for inclusion was the presence of both a malignant glandu lar or squamous epithelial component, and a homologous or heterologous stro mal component. Results: Overall 2- and 5-year cancer related Kaplan-Meier survival estimat es with 95% confidence intervals were 44 (.28, .59) and 26% [.12, .39], res pectively. Survivals were 83 [.62, .99] and 58% [.31, .85] when disease was confined to the uterus, and 22 [.03, .41] and 7% [.01, .20] when disease e xtended beyond the uterus. Clinical staging was often inaccurate, with 29% of clinical stage I or II disease being upstaged at laparotomy. A significa nt survival advantage was found in patients with stage I or II disease trea ted with surgery plus pelvic irradiation (p = 0.001), as compared to those treated with surgery alone. The prognosis after disease recurrence was poor , irrespective of secondary therapy, with a median survival of II months. Conclusions. A therapeutic advantage may be gained from postoperative pelvi c irradiation in the treatment of surgical stage I or II uterine MMT.