Adjuvant Treatment Modalities, Prognostic Factors, and Outcome of the Uterine Carcinosarcoma

J Obstet Gynaecol Can. 2021 Jan;43(1):34-42. doi: 10.1016/j.jogc.2020.06.021. Epub 2020 Jul 18.


Objective: To determine the impact of adjuvant therapy and other factors associated with the recurrence and survival of patients with uterine carcinosarcoma (UCS).

Methods: A total of 102 patients who underwhent surgery for UCS from 1998 to 2017 were included in the analysis. Data were analyzed using Kaplan-Meier methods and Cox proportional hazards regression.

Results: At 240 months, the actuarial recurrence rate was 34.3%. Distant recurrence was the most common recurrence pattern. Patients with higher CA 125 levels, sarcoma dominance, cervical involvement, advanced stage, no lymphadenectomy, and residual tumour had a significiantly higher risk of recurrence. Five-year disease-free survival (DFS) and overall survival (OS) were 67% and 77%, respectively. FIGO stage was found to be an independent prognostic factor for DFS and OS. Sarcoma dominance was independently associated with decreased OS.

Conclusion: Sarcoma dominance is associated with poor survival in UCS. Adjuvant treatment was not found to affect recurrence or survival. Given this finding, more effective postoperative strategies are needed.

Keywords: carcinosarcoma; mixed tumor, mullerian; radiotherapy; uterine neoplasms.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinosarcoma / pathology
  • Carcinosarcoma / therapy*
  • Chemotherapy, Adjuvant / methods*
  • Female
  • Humans
  • Middle Aged
  • Mixed Tumor, Mullerian / pathology
  • Mixed Tumor, Mullerian / therapy*
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Staging
  • Prognosis
  • Radiotherapy, Adjuvant / methods*
  • Retrospective Studies
  • Treatment Outcome
  • Uterine Neoplasms / pathology
  • Uterine Neoplasms / therapy*