Adjuvant Treatment Modalities, Prognostic Predictors and Outcomes of Uterine Carcinosarcomas

Abstract

PurposeThe purpose of this study is to evaluate the clinicopathological characteristics, treatment, and prognosis of uterine carcinosarcoma (UC).Materials and MethodsA retrospective review of three cancer registry databases in Turkey was conducted for identification of patients diagnosed with UC between January 1, 1996, and December 31, 2012. We collected clinicopathological data in order to evaluate factors important in disease- free survival (DFS) and overall survival (OS).ResultsA total of 66 patients with UC with a median age of 65.0 years were included in the analysis. The median survival time of all patients was 37.5 months and the 5-year OS rate was 59.1%. In early stage patients (I-II) who received adjuvant chemotherapy (CT) with radiation therapy (RT), the median DFS and OS was 44 months and 55 months, respectively, compared to 34.5 months and 36 months, respectively, in patients who received adjuvant RT or CT alone (hazard ratio [HR], 1.4; 95% confidence interval [CI], 0.7 to 3.1 for DFS; p=0.23 and HR, 2.2; 95% CI, 0.9 to 5.3 for OS; p=0.03). In advanced stage patients (III-IV), the median DFS and OS of patients receiving adjuvant RT with CT was 25 months and 38 months, respectively, compared to 23.5 months and 24.5 months, respectively, in patients receiving adjuvant RT or CT alone (HR, 3.1; 95% CI, 0.6 to 16.0 for DFS; p=0.03); (HR, 3.3; 95% CI, 0.7 to 15.0 for OS; p=0.01). In multivariate analysis, advanced International Federation of Gynecology and Obstetrics (FIGO) stage and suboptimal surgery showed significant association with poor OS.ConclusionIn patients with early or advanced stage UC, adjuvant CT with RT is associated with improved DFS and OS, as compared to CT or RT alone.

Clinicopathological characteristics, treatment and outcomes in uterine carcinosarcoma and grade 3 endometrial cancer patients: a comparative study

“…In the present study, we observed that adjuvant RT with CT was predictive of better survival in UCS patients compared with individuals receiving CT or RT alone. Gungorduk et al [ 24 ] conducted a retrospective review of three cancer centers involving 66 UCS patients, noting that adjuvant CT with RT is associated with improved OS compared with CT or RT alone (HR, 3.3; 95% CI, 0.7 to 15.0; p=0.01), consistent with the results of the present study. We collected a larger number of cases and prospective trials warranting the evaluation of the effectiveness of multimodal therapy in UCS patients.…”

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

“…92.9% of the women in our study were postmenopausal, but none had a history of previous pelvic irradiation or tamoxifen use. Previously reported mean of age at diagnosis is 62 years [9], which is in line with our results (69.2 years).…”

“…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]. This retrospective study evaluates the clinical presentation, treatment and survival of Caucasian patients diagnosed with UCS in the Comprehensive Cancer Network south region in the Netherlands.…”

Cutaneous Carcinosarcoma: a Clinicopathologic and Immunohistochemical Analysis of 11 Korean Cases

“…The term carcinosarcoma was first used by Virchow in 1864 2. Carcinosarcomas can occur in diverse organs, such as the skin, lungs, esophagus, colon, and uterus 3456. Dawson7 is credited with describing the first cutaneous carcinosarcoma in 1972.…”