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Uterine and Ovary Carcinosarcomas: Outcome, Prognosis Factors, and Adjuvant Therapy

Pacaut, Cécile MD*; Bourmaud, Aurélie MD; Rivoirard, Romain MD*; Moriceau, Guillaume MD*; Guy, Jean-Baptiste MD; Collard, Olivier MD*; Bosacki, Claire MD*; Jacquin, Jean-Philippe MD*; Levy, Antonin MD§; Chauleur, Céline MD, PhD; Magné, Nicolas MD, PhD; Merrouche, Yacine MD, PhD*

American Journal of Clinical Oncology: June 2015 - Volume 38 - Issue 3 - p 272–277
doi: 10.1097/COC.0b013e3182979b27
Original Articles: Gynecologic
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Objectives: The aim of this study was to assess the outcome and the prognosis factors of uterine and ovarian carcinosarcomas.

Methods: From January 1993 to January 2010, data from 68 consecutively treated patients with uterine (n=59) and ovarian (n=9) carcinosarcomas were retrospectively analyzed in a single French comprehensive cancer center.

Results: The median follow-up was 24.2 months (interquartile range [IQR]: 13.5 to 54.6). The median age was 69 years (IQR: 63 to 77). Patients were classified as FIGO stage I (n=28; 41%) and FIGO stage II to IV (n=40; 59%), respectively. There were 33 (49%) and 29 (43%) homologous and heterologous type, respectively. The median disease-free survival and overall survival were 21.9 months (IQR: 7.9 to 22.3) and 27.1 months (IQR: 14.5 to 72), respectively. No statistical differences of survival were reported concerning the initial location of the carcinosarcoma (uterine vs. ovarian). Radiation therapy (hazards ratio [HR]=0.3; 95% confidence interval [CI], 0.16-0.67) and FIGO stage I (HR=0.4; 95% CI, 0.17-0.9) were associated with an increased disease-free survival. Homologous type (HR=3; 95% CI, 1.4-6.3) and FIGO stage II to IV (HR=2.64; 95% CI, 1.3-5.4) were associated with a decreased overall survival. There was no survival improvement for the 12% of patients receiving a multimodal adjuvant therapy.

Conclusions: Uterine and ovary carcinosarcomas present a worse prognosis. On the basis of the present study data, although it should be prospectively confirmed, a sequential or multimodal adjuvant therapy should be proposed to patients with early-stage uterine and ovary carcinosarcomas.

Supplemental Digital Content is available in the text.

*Département d’Oncologie Médicale

Département de Santé Publique

Département de Radiothérapie, Institut de Cancérologie Lucien Neuwirth

§Département d’Oncologie Radiothérapie, Institut Gustave Roussy, Université Paris Sud, Paris

Service de Chirurgie Gynécologique, CHU Nord de Saint-Etienne, Saint Etienne, France

Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website, www.amjclinicaloncology.com.

The authors declare no conflicts of interest.

Reprints: Nicolas Magné, MD, PhD, Department of Radiotherapy, Institut de Cancérologie Lucien Neuwirth, 108 bis, Avenue Albert Raimond—BP 60008, 42271 Saint Priest en Jarez cedex, France. E-mail: nicolas.magne@icloire.fr.

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