Management and clinical outcomes in uterine malignant mixed Müllerian tumor: Lessons from a single-institution series

Abstract

Malignant mixed Müllerian tumor remains an important contributor to morbidity and mortality in women with uterine cancer. Surgery is the primary treatment modality, followed by chemotherapy and/or radiation for advanced disease or high-risk patients. Clinico-epidemiologic characteristics and outcomes in older versus younger women with Malignant mixed Müllerian tumor may differ. We analyzed and now report on 15 consecutive patients with uterine Malignant mixed Müllerian tumor treated at our institution from 2000 to 2018. The mean age at diagnosis was 65 years; 60% (9/15) patients were overweight/obese. Forty-six percent (7/15) had hypercholesterolemia, an association not previously linked with Malignant mixed Müllerian tumor in the literature. All patients but one had surgical excision of the tumor. A third of patients received adjuvant radiation therapy. A majority of patients received chemotherapy; the preferred regimen was carboplatin-paclitaxel. The patients older than 70 had a tendency towards a more advanced disease stage at diagnosis and a significantly shorter cancer-specific survival than their younger counterparts (6 months vs. 102 months (hazard ratio 1.32, p = 0.02)). Our study's conclusions are restricted due to its relatively small size, retrospective design, and some variation in the chemotherapy doses administered in individual patients. Larger studies are needed to confirm the significance of our findings.

Malignant mixed mullerian tumors: a SEER database review of rurality and treatment modalities on disease outcome

“…The use of adjuvant chemotherapy and radiation therapy has both increased over time and improved the OS of patients with MMMTs ( 7 ). A study of older MMMT patients did not find sufficient data to suggest restricting adjuvant radiation (p = 0.28) or chemotherapy (p = 0.61) as further treatment options, even in late-stage disease ( 36 , 37 ). Similarly, the present examination found adjuvant chemotherapy and radiation to both individually offer a survival benefit.…”