Clinical outcomes of uterine carcinosarcoma: results of 94 patients

Int J Gynecol Cancer. 2015 Feb;25(2):279-87. doi: 10.1097/IGC.0000000000000347.

Abstract

Objective: We aimed to determine the clinicopathologic features and identify prognostic factors of patients with uterine carcinosarcoma.

Materials and methods: A total of 94 patients with uterine carcinosarcoma who were diagnosed between January 1993 and October 2013 were included. Staging surgery consisted of total abdominal hysterectomy, bilateral salpingo-oophorectomy, pelvic and para-aortic lymphadenectomy, peritoneal cytology, and omentectomy. Staging is undertaken according to the 2009 International Federation of Gynecology and Obstetrics staging system. Kaplan-Meier survival analysis was used to determine the effects of variables on disease-free survival (DFS) and overall survival (OS).

Results: Seventy-nine patients underwent staging surgery and none of them had residual tumor after surgery. Three-year DFS and 3-year OS were 42.7% and 59.2%, respectively. In the univariate analysis, stage, presence of para-aortic metastatic lymph nodes, uterine serosal spread, positive peritoneal cytology, and extrapelvic metastases were associated with 3-year DFS and stage, presence of para-aortic metastatic lymph nodes, uterine serosal spread, positive peritoneal cytology, adnexal involvement, and extrapelvic metastases were associated with 3-year OS. Seventy-four patients received adjuvant therapy. Adjuvant therapy did not reduce recurrence or improve survival. Any of the chemotherapy regimens was not superior to the others. In the multivariate analysis, only age was an independent prognostic factor for 3-year DFS and no parameter was statistically significant for 3-year OS.

Conclusions: Age was an independent prognostic factor for 3-year DFS. Older age was associated with poor survival. Extrauterine spread was associated with survival. The aims of surgery should be both staging and providing tumoral debulking. Prospective randomized trials are needed to better define the necessity and modality of the administered adjuvant therapy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinosarcoma / diagnosis*
  • Carcinosarcoma / mortality
  • Carcinosarcoma / surgery
  • Carcinosarcoma / therapy*
  • Chemoradiotherapy, Adjuvant / statistics & numerical data
  • Chemotherapy, Adjuvant / statistics & numerical data
  • Combined Modality Therapy
  • Female
  • Humans
  • Hysterectomy / statistics & numerical data
  • Middle Aged
  • Neoplasm, Residual
  • Prognosis
  • Radiotherapy, Adjuvant / statistics & numerical data
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome
  • Uterine Neoplasms / diagnosis*
  • Uterine Neoplasms / mortality
  • Uterine Neoplasms / surgery
  • Uterine Neoplasms / therapy*