Carcinosarcoma of the ovary

Abstract

BACKGROUNDA review of clinicopathologic features and outcome in women with carcinosarcoma of the ovary (also known as malignant mixed mesodermal tumor [MMMT]) compared with a group of women with serous adenocarcinoma (SAC) of the ovary was conducted.METHODSBetween 1984 and 2002, 1568 patients with epithelial ovarian carcinoma and 70 patients with ovarian carcinosarcoma underwent treatment at the Edinburgh Cancer Centre. Analysis was performed on 65 patients with MMMT, and 746 patients with SAC were selected as a group for comparison. Baseline variables were recorded prospectively and response to chemotherapy and progression‐free and cause‐specific survival between the groups were compared.RESULTSPatients with carcinosarcoma had a mean age of 66.6 years, which is significantly older than those with SAC (62.0 years) (P < 0.001). The objective response rate to platinum‐based chemotherapy was found to be significantly lower in patients with carcinosarcoma (25% vs. 60%; P = 0.02). Cause‐specific survival in the carcinosarcoma group was poor and significantly shorter than that observed in the SAC group (median survival of 8.2 months vs. 20.7 months; P < 0.0001). Progression‐free survival in patients with carcinosarcoma also was found to be significantly shorter compared with patients with SAC (median progression‐free survival of 6.4 months vs. 12.1 months; P < 0.001). Achieving optimal debulking at the time of initial surgery was found to be a highly significant factor in patients with carcinosarcoma with regard to determining outcome (median survival of 14.8 months for patients with optimally debulked International Federation of Gynecology and Obstetrics Stage III disease vs. 3.1 months for patients with suboptimally/nondebulked Stage III disease; P < 0.001).CONCLUSIONSOvarian carcinosarcoma is a distinct entity with a poor prognosis. Patients with carcinosarcoma differ from those with SAC with regard to having an older mean age of onset, an inferior response to platinum‐based chemotherapy, and worse progression‐free and cause‐specific survival. The extent of benefit from chemotherapy is unclear. Cancer 2004. © 2004 American Cancer Society.

Carcinosarcoma of the Ovary: Analysis of 13 Cases and Review of the Literature

“…Due to the small number in our study, the majority of patients (12) were stage IIIC and 1 stage IVB and all were older with an average age of 65 years. Similarly to the results reported by Brown et al and Muntz et al [3,11], and in contrast to those published by Barakat et al [12], our study found a trend toward improved survival after optimal debulking, with a median survival of 30 months in patients who were optimally debulked compared to a median survival of 5 months in patients who were suboptimally debulked.…”

“…12 were stage IIIC and 1 stage IVB. In contrast to Brown et al [3], it is interesting to note that in our study the positivity of CA-125 at diagnosis was present in 10 cases and it was not correlated with a poor prognosis. This was probably due to the small number of our series.…”

Prolonged response to trabectedin in a patient with carcinosarcoma of the ovary refractory to adjuvant platinum-taxane

“…Owing to the rarity of ovarian carcinosarcomas, there is no established chemotherapy regimen [2] . Lesier et al have evaluated the combination of platinum and taxane either after initial tumor resection or as neoadjuvant therapy [9] .…”

“…Ovarian carcinosarcoma, also known as malignant mixed Müllerian or mesodermal tumor (MMMT), is uncommon accounting for approximately 1% to 2% of all ovarian malignancies [1,2] . In the female genital tract, carcinosarcomas usually arise in the uterus and much less frequently in the ovary, vagina and cervix, with a tendency to affect the elderly population [3] .…”

“…No effective chemotherapeutic regimen and radiotherapy exist. Optimal cytoreductive surgical debulking is crucial and the FIGO stage is considered as the only prognostic factor [2] .…”