Article Text

Download PDFPDF
Ovarian and Uterine Carcinosarcomas: A Comparative Analysis of Prognostic Variables and Survival Outcomes
  1. Gunjal Garg, MD*,
  2. Jay P. Shah, MD,
  3. Sanjeev Kumar, MD,
  4. Christopher S. Bryant, MD,
  5. Adnan Munkarah, MD§ and
  6. Robert T. Morris, MD, PhD
  1. * Department of Obstetrics and Gynecology, Detroit Medical Center, Detroit, MI;
  2. Division of Gynecologic Oncology, Wayne State University, Detroit, MI;
  3. Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI; and
  4. § Division of Gynecologic Oncology, Henry Ford Hospital, Detroit,MI.
  1. Address correspondence and reprint requests to Gunjal Garg, MD, Suite 304, 4727 St Antoine St, Detroit, MI 48201. E-mail: gunjalgarg{at}


Introduction: Carcinosarcomas (malignant mixed Mullerian tumor) of the female genital tract are rare tumors associated with poor outcome. The objective of this study was to identify site-specific differences by comparing carcinosarcomas originating in the uterus and the ovaries.

Methods: Data on patients with uterine and ovarian carcinosarcomas were extracted from the Surveillance, Epidemiology, and End Results database between 1988 and 2005. Kaplan-Meier log rank and Cox proportional hazards models were used for survival analysis and for identification of possible predictors for survival.

Results: The identified cohort included 3683 women of whom 2759 (75%) have uterine carcinosarcoma and 924 (25%) have ovarian carcinosarcomas. The patients with uterine carcinosarcoma were older than the patients with ovarian carcinosarcoma (median age, 67 vs 65 years; P < 0.001). The women with uterine carcinosarcoma compared with those with ovarian carcinosarcoma were more often African American (17.3% vs 6%; P < 0.001) and presented more often with localized disease (47% vs 10.8%; P < 0.001). Uterine carcinosarcoma compared with ovarian carcinosarcoma differed significantly with regard to the performance of lymphadenectomy (62.6% vs 41.2%; P < 0.001) and the administration of radiotherapy (38.2% vs 4.8%; P < 0.001). When controlled for the extent of disease spread, uterine carcinosarcoma had a more aggressive clinical course and shorter survival compared with ovarian carcinosarcoma. Although age (P < 0.001), race (P = 0.01), stage (P < 0.001), lymphadenectomy (P < 0.001), and radiation (P < 0.001) were all significant prognostic factors in uterine carcinosarcoma, only age (P < 0.001), stage (P < 0.001), and lymphadenectomy (P < 0.001) were significant predictors in ovarian carcinosarcoma.

Conclusion: Although uterine carcinosarcoma presents at an earlier stage than ovarian carcinosarcoma, it has a worse prognosis compared with ovarian carcinosarcoma, with a similar extent of disease spread. Improved survival observed in lymphadenectomy group lends support to its routine performance in patients with uterine and ovarian carcinosarcomas.

  • Ovarian carcinosarcoma
  • Uterine carcinosarcoma
  • Prognosis
  • Survival

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.