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Primary Treatment and Prognostic Factors of Carcinosarcoma of the Ovary, Fallopian Tube, and Peritoneum: A Taiwanese Gynecologic Oncology Group Study

Lu, Chien-Hsing MD, PhD*†; Chen, I-Hui MD; Chen, Yi-Jen MD, PhD†§; Wang, Kung-Liahng MD∥¶#; Qiu, Jian-Tai Timothy MD, PhD**††; Lin, Hao PhD††‡‡; Lin, Wu-Chou MD§§; Liou, Wen-Shiung MD∥∥; Huang, Yu-Fang MD¶¶; Lin, Yue-Shan MD##; Tee, Yi-Torng MD***; Hung, Yao-Ching MD, PhD§§†††

International Journal of Gynecological Cancer:
doi: 10.1097/IGC.0000000000000083
Ovarian Cancer
Abstract

Objective: This study aimed to determine the clinical prognostic factors involved in carcinosarcoma of the ovary, fallopian tube, and peritoneum.

Materials and Methods: This retrospective study was undertaken by the Taiwanese Gynecologic Oncology Group. The retrieved clinical data included demographic characteristics, medical disease, tumor status, extent of surgery, and adjuvant chemotherapy.

Results: In total, 63 patients with carcinosarcoma of the ovary, fallopian tube, and peritoneum were identified. Sixty-one patients with complete data were enrolled for further data analysis. The mean follow-up period was 1.0 year, and the mean overall survival was 15.4 months. By log-rank tests, age, menopausal status, parity, hypertension, diabetes, primary tumor size, para-aortic lymph node metastasis, pretreatment CA-125, preceding diagnostic surgery, hysterectomy, lymphadenectomy, other surgeries, and paclitaxel use were not predictive of overall survival.

Omentectomy, no gross residual implants after surgery, platinum treatment, and no pelvic lymph node metastasis had a trend toward better survival. Early diagnosis at stage I and cisplatin/ifosfamide regimen were significant associated with a better overall survival in log-rank and simple Cox regression tests. Bilateral ovarian tumors and metastatic tumors larger than 2 cm were significantly associated with a poorer overall survival.

Conclusions: Early diagnosis at stage I, unilateral ovarian tumor, metastatic tumors less than 2 cm, and cisplatin/ifosfamide regimen were predictive of a better survival.

Omentectomy and complete debulking surgery also showed a trend toward better survival. Thus, these treatment strategies should be applied in patients with carcinosarcoma of the ovary, fallopian tube, and peritoneum.

Author Information

*Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung; †Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei; ‡Obstetrics and Gynecology Department, National Taiwan University Hospital, Hsin-Chu branch, Hsin-Chu; §Department of Obstetrics and Gynecology, Taipei Veterans General Hospital; ∥Department of Obstetrics and Gynecology, Mackay Memorial Hospital; ¶Department of Nursing, Mackay Medicine, Nursing and Management College; #Department of Obstetrics and Gynecology, Taipei Medical University, Taipei; **Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital; ††Chang Gung University College of Medicine, Taoyuan; ‡‡Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital-Kaohsiung, Kaohsiung; §§Department of Obstetrics and Gynecology, China Medical University Hospital, Taichung; ∥∥Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung; ¶¶Department of Obstetrics and Gynecology, National Cheng Kung University and Hospital; ##Department of Obstetrics and Gynecology, Chi-Mei Medical Center, Tainan; ***Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung; and †††College of Medicine, China Medical University, Taichung, Taiwan.

Address correspondence and reprint requests to Yao-Ching Hung, MD, PhD, Department of Obstetrics and Gynecology, China Medical University Hospital, No. 2, Yuh-Der Rd, Taichung 404, Taiwan. E-mail: d6375@mail.cmuh.org.tw.

Details of ethics approval: Institutional review board, Taichung Veterans General Hospital, No. C10242. Date of approval: Jan. 12, 2011, and institutional review board from each participating hospital.

The authors declare no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal’s Web site (www.ijgc.net).

Received October 8, 2013

Accepted December 4, 2013

© 2014 by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology.