Clinical Characteristics, Surgical Management and Adjuvant Therapy of Patients with Uterine Carcinosarcoma: A Retrospective Case Series

Wallwiener, Christian W.; Hartkopf, Andreas D.; Kommoss, Stefan; Joachim, Clarisse; Wallwiener, Markus; Taran, Florin‐Andrei; Brucker, Sara Y.

doi:10.1055/s-0042-100205

Cited by 7 publications

(14 citation statements)

References 32 publications

(53 reference statements)

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“…The average age was 58.6 ± 11.0 years (median, 59 years), which was in accordance with recent Chinese and Korean reports [3,12] but was different from that of several international reports [13,14] (average age was 65 years); this discrepancy may have been influenced by the race of the patients. The symptoms of UCS are postmenopausal vaginal bleeding and menstrual disorders, vaginal discharge caused by necrosis or infection of the lesions, and the presence of an abdominal mass.…”

Section: Ultrasonographic Characteristicssupporting

confidence: 71%

Ultrasonographic Findings of Uterine Carcinosarcoma

Zhao

Zhang

et al. 2018

Gynecol Obstet Invest

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Aims: The aim of this study was to investigate the clinical features and ultrasonographic findings of uterine carcinosarcoma (UCS). Methods: Seventy-five patients (mean age, 58.6 years) with pathologically proven UCS who were treated at our hospital from January 2003 to December 2015 were retrospectively recruited. The clinical features and preoperative findings on transvaginal sonography (TVS) were investigated. Results: Eighty percent of the patients were postmenopausal. The primary symptoms were postmenopausal abnormal uterine bleeding (57.3%), irregular menstruation (18.7%), vaginal discharge (10.7%) and the presence of a uterine mass or others (13.3%). The tumor marker CA125 was evaluated in 43 women and was found to be elevated in 15 (34.9%); in 60% of those women (9/15), the CA125 level was lower than 200U/ml. According to the frequency of the different types of lesions observed by ultrasonic imaging, we decided to categorize the lesions into 3 different groups as follows: Group I, intrauterine tumors (73.33%); group II, intra-myometrial tumors (13.33%); and group III, intra-endometrial tumors (13.33 %). Conclusion: Combined with the clinical features, the characteristics demonstrated by TVS provide evidence for an indication of the presence of UCS and could contribute to clinical decision-making.

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Section: Ultrasonographic Characteristicssupporting

confidence: 71%

Ultrasonographic Findings of Uterine Carcinosarcoma

Zhao

Zhang

et al. 2018

Gynecol Obstet Invest

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“…The most frequent surgical approach adopted in early UCSs is laparotomy, and few retrospective data are available relative to the minimally invasive surgery in UCSs (Wallwiener et al 2016 ; Tan et al 2017 ; Dellinger et al 2017 ); within the GOG LAP2 trial (Walker et al 2009 ), which has investigated the clinical outcome of early-stage EC patients triaged to laparoscopic versus laparotomic surgery, the sub-group analysis of “high risk” histotypes (i.e. clear cells, serous, and UCSs) reported similar rates of recurrence and survival between the two approaches (Fader et al 2016 ).…”

Section: Introductionmentioning

confidence: 99%

Role of minimally invasive surgery versus open approach in patients with early-stage uterine carcinosarcomas: a retrospective multicentric study

Corrado

Ciccarone

Cosentino

et al. 2020

J Cancer Res Clin Oncol

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Objective The aim of this retrospective study was to compare surgical and survival outcome in only patients with early-stage UCSs managed by laparotomic surgery (LPT) versus minimally invasive surgery (MIS). Methods Data were retrospectively collected in four Italian different institutions. Inclusion criteria were UCS diagnosis confirmed by the definitive histological examination, and stage I or II according to the FIGO staging system. Results Between August 2000 and March 2019, the data relative to 170 patients bearing UCSs were collected: of these, 95 were defined as early-stage disease (stage I–II) based on the histological report at the primary surgery, and thus were included in this study. Forty-four patients were managed by LPT, and 51 patients were managed by MIS. The operative time was lower in the MIS group versus the LPT group (p value 0.021); the median estimated blood loss was less in the MIS group compared to the median of LPT group (p value < 0.0001). The length of hospital stay days was shorter in the MIS patients (p value < 0.0001). Overall, there were eight (8.4%) post-operative complications; of these, seven were recorded in the LPT group versus one in the MIS group (p value 0.023). There was no difference in the disease-free survival (DFS) and overall survival (OS) between the two groups. Conclusion There was no difference of oncologic outcome between the two approaches, in face of a more favourable peri-operative and post-operative profile in the MIS group.

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“…Currently, there is no clear guideline for therapeutic management of carcinosarcoma. Optimal treatment strategies are still not established for both surgery and adjuvant treatment [7,8], although surgery is still considered the corner stone of treatment of this disease. Due to limited data and only few prospective trials on treatment of this disease, this issue has not been clarified [11].…”

Section: Discussionmentioning

confidence: 99%

“…The standard of care in early-stage disease is surgery consisting of hysterectomy with or without bilateral salpingo-oophorectomy [3]. For late-stage disease, cytoreductive surgery has shown to increase OS [3,7]. Concerning adjuvant therapy, there is ongoing discussion whether it improves survival and until now no evidence-based treatment strategy is established [8,9].…”

Section: Introductionmentioning

confidence: 99%

Treatment and Outcome of Patients with Uterine Carcinosarcoma in a Comprehensive Cancer Network

Hapsari

Bhugwandass²,

Rijn³

et al. 2019

Indian J Gynecol Oncolog

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Aim To determine clinical characteristics, treatment modalities and survival of uterine carcinosarcoma (UCS). Methods Data on treatment of UCS patients in the Comprehensive Cancer Network south region in the Netherlands between 2004 and 2014 were retrospectively evaluated. Results Data of 62 patients with UCS were retrieved. Mean age at diagnosis was 69.2 years (45-95 years). Data of six patients were excluded because they did not receive any treatment. Of the 56 patients included in this study, 57.1% presented with early-stage (FIGO I-II) disease and 42.9% with late-stage (FIGO III-IV) disease. 46.9% of the patients with FIGO early-stage disease received only surgical treatment, whereas 9.4% received adjuvant chemotherapy and 43.8% received adjuvant radiotherapy. Median DFS in patients with early-stage disease was 47.0 months (17.5-72.0). Adjuvant therapy did not seem to alter prognosis (p = 0.261). 16.7% of the patients with late-stage disease received only surgical treatment, 12.5% received only chemotherapy, whereas 50% received adjuvant chemotherapy and 20.8% adjuvant radiotherapy after surgery. Median DFS in late-stage disease was 8.5 months (2.5-23.5). Adjuvant therapy did not seem to alter prognosis (p = 0.30). Conclusion UCS with both FIGO stages I-II and III-IV has a dismal prognosis. The addition of adjuvant treatment did not seem to increase survival.

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Clinical Characteristics, Surgical Management and Adjuvant Therapy of Patients with Uterine Carcinosarcoma: A Retrospective Case Series

Abstract: !Purpose: To review a single-center experience over a 27-year period of managing uterine carcinosarcoma (UCS), focusing on surgical practice, adjuvant therapy and clinical outcome.

Cited by 7 publications

References 32 publications

Ultrasonographic Findings of Uterine Carcinosarcoma

Ultrasonographic Findings of Uterine Carcinosarcoma

Role of minimally invasive surgery versus open approach in patients with early-stage uterine carcinosarcomas: a retrospective multicentric study

Treatment and Outcome of Patients with Uterine Carcinosarcoma in a Comprehensive Cancer Network

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