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An Update on the Management of Uterine Carcinosarcoma

Gurumurthy, Mahalakshmi MRCOG*; Somoye, Gbolohan MRCOG†; Cairns, Mary MRCOG‡; Parkin, David E. MD, FRCOG‡

Obstetrical & Gynecological Survey: November 2011 - Volume 66 - Issue 11 - pp 710-716
doi: 10.1097/OGX.0b013e31823e0c44
CME Program: CME REVIEW ARTICLE 32

Carcinosarcomas are rare aggressive neoplasms with a poor prognosis. The recent International Federation of Gynecology and Obstetrics (FIGO) 2009 categorizes uterine carcinosarcoma into the endometrial carcinoma group. This review highlights the prognosis, recurrence rate, and the treatment modalities. The primary treatment is surgery. Lymphadenectomy as part of the surgical procedure has shown to prolong survival even for early-stage disease. A combined chemo-radiotherapeutic approach has shown a survival benefit. Radiotherapy from various studies has shown a significant effect on local control of the disease, with no obvious benefit on overall survival. Various trials led by the gynecologic oncology group looking into different chemotherapeutic combinations have showed differing response rates. In the future, the emergence of combination of chemotherapeutic agents with molecular-targeted agents may show promising results.

Target Audience: Obstetricians & Gynecologists and Family Physicians

Learning Objectives: After completing this CME activity, physicians should be better able to appraise the aggressive nature of uterine carcinosarcoma and factors which would help in delaying or preventing recurrence, assess the importance of lymphadenectomy for uterine carcinosarcoma and its effect on survival, and evaluate various recent trials addressing the chemo-radiotherapeutic combinations as adjuvant therapy.

*Clinical Research Fellow, Department of Gynecological Oncology, †Subspecialist Trainee, Department of Gynecological Oncology and ‡Consultant, Department of Gynecological Oncology, Aberdeen Royal Infirmary, Aberdeen, United Kingdom

Chief Editor's Note: This article is part of a series of continuing education activities in this Journal through which a total of 36 AMA/PRA Category 1 Credits™ can be earned in 2011. Instructions for how CME credits can be earned appear on the last page of the Table of Contents.

The authors, faculty and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interest in, any commercial organizations pertaining to this educational activity.

Correspondence requests to: Mahalakshmi Gurumurthy; MRCOG, Department of Gynecological Oncology, Aberdeen Royal Infirmary, Ward 43, Forester hill Road, Aberdeen, United Kingdom, AB25 2ZN. E-mail: m.gurumurthy@nhs.net.

© 2011 Lippincott Williams & Wilkins, Inc.