Management and Prognosis of Patients with Recurrent or Persistent/Progressive Uterine Carcinosarcoma

Curr Oncol. 2022 Oct 13;29(10):7607-7623. doi: 10.3390/curroncol29100601.


Uterine carcinosarcoma (UCS) is a highly aggressive gynecologic malignancy. Recurrent or persistent/progressive disease is usually fatal. We aimed to investigate the management and prognosis of these patients. Clinical records of UCS patients from June 1987 to April 2020 were retrospectively reviewed. The stage was re-assigned with the FIGO 2009 staging system. Univariate and multivariate analyses were used to identify the independent predictors of survival after recurrence (SAR) and cancer-specific survival (CSS). Of the 168 patients, 98 experienced treatment failure. The median time to treatment failure (TTF) was 8.1 months (range: 0.0-89.1). The median follow-up time of censored patients was 32.0 months (range: 16.8-170.7). The 5-year SAR rates of those with recurrent or persistent/progressive disease were 7.6%. On multivariate analysis, salvage therapy mainly using radiotherapy (HR 0.27, 95% CI: 0.10-0.71) or chemotherapy (HR 0.41, 95% CI: 0.24-0.72) or chemoradiotherapy (CRT) (HR 0.33, 95% CI: 0.15-0.75) were associated with improved SAR, whereas disseminated recurrence was associated with significantly worse SAR (HR 3.94, 95% CI: 1.67-9.31, p = 0.002). Salvage therapy using radiotherapy or chemotherapy or CRT significantly improved SAR. Surgery significantly improved CSS but not SAR, adjusting for confounding factors.

Keywords: MMMT; carcinosarcoma; endometrial cancer; survival after recurrence.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Carcinosarcoma* / pathology
  • Carcinosarcoma* / surgery
  • Female
  • Humans
  • Prognosis
  • Radiotherapy, Adjuvant
  • Retrospective Studies
  • Uterine Neoplasms* / drug therapy
  • Uterine Neoplasms* / pathology

Grant support

This work was financially supported by grants from Ministry of Health and Welfare, Taiwan: MOHW110-TDU-B-212-124005 and MOHW111-TDU-B-212-134005.