Analysis of clinicopathologic factors in malignant mixed Mullerian tumors of the uterine corpus

Abstract

The aim of this study was to retrospectively analyze the clinical and pathologic data of a series of patients presenting to our unit with uterine malignant mixed Müllerian tumors (MMMT) to attempt to identify prognostic factors and relate them to survival. Thirty-seven patients diagnosed with MMMT of the uterus from 1988 through 2000 were identified from the gynecological tumor registry. Data was abstracted and analyzed. The effect of a variety of clinical, histopathologic, and surgical variables on recurrence and survival were analyzed by univariate and multivariate analyses. Patients tended to be postmenopausal, overweight, hypertensive, and presented with abnormal bleeding. Preoperatively 28 (76%) were thought to have clinical stage I-II disease. Nine (32%) were upstaged based on surgical data. Five (56%) of these patients were found to have gross extrauterine disease and four (44%) were found subsequently to have microscopic extrauterine disease. Twenty (54%) patients underwent lymph node dissection and positive nodes were found in seven (35%) patients. Nine patients underwent omentectomy and disease was found in three (33%). Peritoneal washings were positive in three of 16 patients (19%). At the completion of primary surgery, 27 (75%) patients had no residual disease. Twelve (44%) of these patients had recurrence of disease. Median disease-free interval prior to first recurrence was 15 months. Median overall survival was 30 months. Log-rank analysis performed on multiple variables, including stage, age, residual disease, and depth of myometrial invasion showed a statistically significant association with overall survival probability. Only stage remained a significant independent variable predictive of overall survival (P = 0.034). We found that stage was an independent prognostic factor for overall survival in patients with uterine MMMT. Age, depth of myometrial invasion, and residual tumor were significant prognostic factors on univariate analysis. These factors may be a guide in order to select a group of high risk patients that may benefit from adjuvant therapy.

Malignant Mixed Müllerian Tumour of the Uterus: Analysis of 44 Cases

“…Unlike what was reported in the review by Kanthan and Senger [1] , in which nulliparity was identified as a risk factor for the development of this tumour, most of our patients were uni-or multiparous (75%). In agreement with the current literature, there was a frequent association with chronic diseases, mainly with hypertension and diabetes [15,20] . In 13.6% of the cases there was an association with breast cancer.…”

“…In 13.6% of the cases there was an association with breast cancer. Over half of the women included in our study had a good performance status, which represents another divergence from the typical patient profile described in many reports [20] . The presenting symptom of this neoplasm often was abnormal uterine bleeding in post-menopause (40.9%) [15] , even if the patients frequently were asymptomatic (54.5%) [21] .…”

Uterine Carcinosarcomas - Diagnosis and Management

“…Other factors that have been associated with prognosis include patient age, LVSI, and presence of gross residual disease [22]. …”

Endometrial stromal sarcoma together with leiomyosarcoma in a single patient: a rare case report

“…2 The third common variant is carcinosarcoma, which is composed of mixture of sarcoma and carcinoma. 3 Almost all of the carcinosarcomas occur after menopause, at a median age of 62 years. It is considered to be highly malignant as the disease extends outside the uterus in 40 to 60 % of cases at the time of diagnosis.…”