Predictive and Prognostic Factors in Ovarian and Uterine Carcinosarcomas

Abstract

Background: Prognostic factors and the standard treatment approach for gynaecological carcinosarco-mas have not yet been clearly defined. Although car-cinosarcomas are more aggressive than pure epithelial tumours, they are treated similarly. Serous/clear cell and endometrioid components may be predictive fac-tors for the efficacy of adjuvant chemotherapy (CT) or radiotherapy (RT) or RT in patients with uterine and ovarian carcinosarcomas. Heterologous carcino-sarcomas may benefit more from adjuvant CT.Aims: We aimed to define the prognostic and predic-tive factors associated with treatment options in ovar-ian (OCS) and uterine carcinosarcoma (UCS).Study Design: Retrospective cross-sectional studyMethods: We retrospectively reviewed the medical re-cords of patients with ovarian and uterine carcinosar-coma from 2000 to 2013, and 127 women were includ-ed in this study (24 ovarian and 103 uterine). Patients admitted to seventeen oncology centres in Turkey be-tween 2000 and December 2013 with a histologically proven diagnosis of uterine carcinosarcoma with FIGO 2009 stage I-III and patients with sufficient data ob-tained from well-kept medical records were included in this study. Stage IV tumours were excluded. The pa-tient records were retrospectively reviewed. Data from 104 patients were evaluated for this study.Results: Age (>=70 years) was a poor prognostic factor for UCS (p=0.036). Pelvic±para aortic lymph node dis-section did not affect overall survival (OS) (p=0.35). Macroscopic residual disease was related with OS (p<0.01). The median OS was significantly longer in stage I-II patients than stage III patients (p=0.03). Adjuvant treatment improved OS (p=0.013). Adju-vant radiotherapy tended to increase the median OS

Background: Prognostic factors and the standard treatment approach for gynaecological carcinosarco-mas have not yet been clearly defined. Although car-cinosarcomas are more aggressive than pure epithelial tumours, they are treated similarly. Serous/clear cell and endometrioid components may be predictive fac-tors for the efficacy of adjuvant chemotherapy (CT) or radiotherapy (RT) or RT in patients with uterine and ovarian carcinosarcomas. Heterologous carcino-sarcomas may benefit more from adjuvant CT.Aims: We aimed to define the prognostic and predic-tive factors associated with treatment options in ovar-ian (OCS) and uterine carcinosarcoma (UCS).Study Design: Retrospective cross-sectional studyMethods: We retrospectively reviewed the medical re-cords of patients with ovarian and uterine carcinosar-coma from 2000 to 2013, and 127 women were includ-ed in this study (24 ovarian and 103 uterine). Patients admitted to seventeen oncology centres in Turkey be-tween 2000 and December 2013 with a histologically proven diagnosis of uterine carcinosarcoma with FIGO 2009 stage I-III and patients with sufficient data ob-tained from well-kept medical records were included in this study. Stage IV tumours were excluded. The pa-tient records were retrospectively reviewed. Data from 104 patients were evaluated for this study.Results: Age (>=70 years) was a poor prognostic factor for UCS (p=0.036). Pelvic±para aortic lymph node dis-section did not affect overall survival (OS) (p=0.35). Macroscopic residual disease was related with OS (p<0.01). The median OS was significantly longer in stage I-II patients than stage III patients (p=0.03). Adjuvant treatment improved OS (p=0.013). Adju-vant radiotherapy tended to increase the median OS