A retrospective study of clinicopathological characteristics, treatment, and outcomes of Chinese uterine and ovarian carcinosarcoma patients

摘要

This study aimed to determine the clinicopathological and prognostic factors, and to assess the impact of cytoreduction to complete gross resection in Chinese uterine and ovarian carcinosarcoma patients. Materials and Methods: The authors reviewed 86 consecutive patients treated for uterine (n= 60) or ovarian (n= 26) carcinosarcomas between February 2006 and August 2013 at Fudan University Shanghai Cancer Center. Results: The median follow- up time was 24.0 months [ interquartile range (IQR): 12.4 to 48.7]. The median age was 59 years (IQR: 53 to 66). The three- and five- year overall survival rates were 60.1% and 42.8%, respectively. Extent of tumor dissemination, mesenchymal component, and adjuvant therapy were predictive of overall survival. Among advanced carcinosarcoma patients, complete gross resection (R-0) had a three- year overall survival rate of 52.5%, vs. 38.9% and 20.8% in patients with gross esidual disease = 1cm and 1cm (p = 0.004). On multivariate analysis, only heterologous mesenchymal component (HR= 4.8; 95% CI, 1.4-16.7; p = 0.015) and gross residual disease (HR= 2.6, 95% CI: 1.2- 5.9; p = 0.019) were predictors of increased mortality. Conclusions: Heterologous tumor and incomplete gross resection were significantly predictive of a poor overall survival in carcinosarcoma patients. We recommend cytoreduction to R0 for upfront treatment in CS patients.