Pathologic variables and adjuvant therapy as predictors of recurrence and survival for patients with surgically evaluated carcinosarcoma of the uterus

Abstract

BACKGROUND The purpose of this study was to determine clinicopathologic variables associated with extrauterine disease, recurrence, and survival in patients with carcinosarcoma (CS) of the uterus. METHODS Patients believed to have disease confined to the uterine corpus who underwent primary surgical assessment were identified and data retrospectively reviewed. RESULTS Occult metastases were found in 38 (61%) of 62 patients. At last follow‐up, 31 (50%) had had recurrence, with an extrapelvic component in 43%, and 53% had died. Depth of myometrial invasion and lymph‐vascular space invasion (LVSI) were associated with extrauterine disease. Five‐year survival for patients with disease confined to the corpus (74%) was significantly greater than for those with more advanced disease (24%, P = 0.0013). Factors associated with recurrence and survival included depth of myometrial invasion, LVSI, adnexal and serosal involvement, positive cytology, and lymph node metastases. Of 24 patients with uterine disease only, 11 received no adjuvant therapy, yet 8 (73%) were free of disease at last follow‐up. Neither adjuvant radiotherapy nor chemotherapy was identified as an independent prognostic variable for recurrence or survival. CONCLUSIONS More than half of patients with CS clinically confined to the uterine corpus harbor occult metastases in a pattern similar to that found with endometrial carcinoma. Survival is significantly diminished for this group. Although the benefit of adjuvant therapy cannot be demonstrated by this study, a number of early stage patients survive without adjuvant therapy. This argues for extending the International Federation of Gynecology and Obstetrics endometrial carcinoma surgical staging system to include CS, and also for conducting prospective trials to examine the benefits of adjuvant therapy for patients with early stage disease. Cancer 2000;88:2782–6. © 2000 American Cancer Society.

Carcinosarcoma of Uterus – A highly Aggressive Tumour – A Case Report

“…15 The median survival for all stage is only 18 months. 16 In general these tumours are thought to carry a poor prognosis. There are virtually no long-term survivors among those whose tumour had extended beyond the uterus at the time of diagnosis.…”

Carcinosarcoma (malignant mixed mesodermal tumor) of the uterus: clinicoimmunohistochemical and histogenetic characteristics

“…Five-year survival for women diagnosed with type I cancer reaches 90%, whereas in those diagnosed with type II cancer, it is between 50% and 60%, and in those diagnosed with carcinosarcoma it is between 33% and 39% [4,[10][11][12][13]. Five-year survival for leiomyosarcoma is assessed to be between 15% and 25%, but for stage I and II it is assessed to be between 40% and 70% [14].…”

Sarcomas Uterinos: Manejo Actual

“…En el caso de tumores mesodérmicos mixtos debido a la alta proporción de citología peritoneal positiva, metástasis anexiales, peritoneales y ganglionares, el tratamiento quirúrgico debiera incorporar lavado peritoneal, omentectomía y linfadenectomía principalmente pelviana (6,13). En pacientes con etapa I y II tratados con radioterapia adyuvante se ha observado mejor control local (7,8,9,11,12,13,17) y sobrevida causa específica (18), siendo su rol en sobrevida global controversial.…”

“…En pacientes con etapa I y II tratados con radioterapia adyuvante se ha observado mejor control local (7,8,9,11,12,13,17) y sobrevida causa específica (18), siendo su rol en sobrevida global controversial.…”