Uterine carcinosarcoma: A 10-year single institution experience

• Published in: PloS one 2022-07, Vol.17 (7), p.e0271526-e0271526
• Main Authors: Terblanche, Leana, Botha, Matthys H
• Format: Article
• Language: English
• Subjects: Biology and Life Sciences; Breast cancer; Care and treatment; Cervix; Chemotherapy; Death; Diagnosis; Disease; Feature recognition; Genetic factors; Genetics; Health aspects; Health care; Health risks; Health services; Lymphatic system; Medical prognosis; Medicine and Health Sciences; Mortality; Multivariate analysis; Myometrium; Patients; Pattern recognition; Pelvis; Radiation; Radiation therapy; Risk; Statistical models; Surgery; Survival; Survival analysis; Tumors; Uterine cancer; Uterus; Women
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0271526

This study aimed to determine 5-year progression-free and overall survival in patients with uterine carcinosarcoma, to determine clinical and surgical-pathologic features, to recognize patterns of recurrence and to identify prognostic factors influencing progression-free survival (PFS) and overall survival (OS). This was a single institution, retrospective 10-year review of patients treated at Tygerberg Hospital in South Africa with pathologically confirmed uterine carcinosarcoma. A total of 61 patients were studied. Demographic, clinicopathological, treatment and outcome information were obtained. Kaplan-Meier survival analysis and Cox proportional hazards models were used to determine the effects of variables on PFS and OS. Eighteen patients (29%) presented as FIGO stage I disease, 5 patients (8%) as stage II, 16 patients (26%) as stage III and 22 patients (36%) as stage IV disease. Fifty of the 61 patients (82%) had surgery. Five-year PFS and 5-year OS were 17.3% (CI 8.9%-27.9%) and 19.7% (CI 10.6%-30.8%), respectively. Seventeen patients presented with recurrence of which 5 (29.4%) were local and 12 (70.6%) were outside the pelvis. Carcinosarcoma is an aggressive cancer with poorer survival in this specific cohort than has been described in other contemporary cohorts. Biological or genetic factors are a possible explanation for lower overall survival in this population. Although it is also possible that later diagnosis and poor access to health care contribute to poorer survival. Most recurrences occur outside of the pelvis. Full staging surgery (including pelvic lymphadenectomy) and additional use of other modalities (either for radical or palliative intent) improve survival.