Cancer Res Treat.  2015 Apr;47(2):282-289. 10.4143/crt.2014.009.

Adjuvant Treatment Modalities, Prognostic Predictors and Outcomes of Uterine Carcinosarcomas

Affiliations
  • 1Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey. isaaykutozdemir@hotmail.com
  • 2Department of Gynecologic Oncology, Osmangazi University School of Medicine, Eskisehir, Turkey.
  • 3Department of Gynecologic Oncology, Bulent Ecevit University School of Medicine, Zonguldak, Turkey.
  • 4Department of Pathology, Tepecik Education and Research Hospital, Izmir, Turkey.

Abstract

PURPOSE
The purpose
of this study is to evaluate the clinicopathological characteristics, treatment, and prognosis of uterine carcinosarcoma (UC).
MATERIALS AND METHODS
A retrospective review of three cancer registry databases in Turkey was conducted for identification of patients diagnosed with UC between January 1, 1996, and December 31, 2012. We collected clinicopathological data in order to evaluate factors important in disease- free survival (DFS) and overall survival (OS).
RESULTS
A total of 66 patients with UC with a median age of 65.0 years were included in the analysis. The median survival time of all patients was 37.5 months and the 5-year OS rate was 59.1%. In early stage patients (I-II) who received adjuvant chemotherapy (CT) with radiation therapy (RT), the median DFS and OS was 44 months and 55 months, respectively, compared to 34.5 months and 36 months, respectively, in patients who received adjuvant RT or CT alone (hazard ratio [HR], 1.4; 95% confidence interval [CI], 0.7 to 3.1 for DFS; p=0.23 and HR, 2.2; 95% CI, 0.9 to 5.3 for OS; p=0.03). In advanced stage patients (III-IV), the median DFS and OS of patients receiving adjuvant RT with CT was 25 months and 38 months, respectively, compared to 23.5 months and 24.5 months, respectively, in patients receiving adjuvant RT or CT alone (HR, 3.1; 95% CI, 0.6 to 16.0 for DFS; p=0.03); (HR, 3.3; 95% CI, 0.7 to 15.0 for OS; p=0.01). In multivariate analysis, advanced International Federation of Gynecology and Obstetrics (FIGO) stage and suboptimal surgery showed significant association with poor OS.
CONCLUSION
In patients with early or advanced stage UC, adjuvant CT with RT is associated with improved DFS and OS, as compared to CT or RT alone.

Keyword

Carcinosarcoma; Uterine neoplasms; Adjuvant chemotherapy; Adjuvant radiotherapy
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