Introduction/Background Uterine Carcinosarcomas (UCs) are composed of both malignant epithelial and mesenchymal components, account for <5% of all gynecological neoplasms and have a highly aggressive clinical course. The aim of this retrospective study was to evaluate the recurrence patterns as well as the clinical and histopathological characteristics of UCs.
Methodology We retrospectively reviewed the clinical and pathology data from 46 patients who underwent surgery between 2012 and 2018 and obtained a diagnosis of UCs. Data analysis included histologic subtype, grade, presence of homologous/heterologous elements, depth of myometrial invasion (MI), disease - free interval (DFI), site of recurrent disease, and overall survival (OS). Data was analyzed using Cox-regression and Kaplan - Meier survival analyses.
Results The median age of our patient sample was 69.9 (range 35–91 years), and median tumor size was 6.4 cm. MI >50% was observed in 68.7%, LVI in 45.6%, and lymph node (LN) metastasis in 19.5%. 60.8% of the patients were diagnosed with stage I disease, 10.8% with stage II, and 28.2% with stage III disease. Serous carcinoma was the predominant carcinomatous component (56.5%), while heterologous elements (43.4%), particularly rhabdomyoblastic differentiation (RMB) (85%) was the most common sarcomatous component. 28% and 65% of patients received adjuvant radiotherapy or chemotherapy, respectively. Median DFI and OS were 10 and 16 months respectively. LN metastasis, tumor size >5 cm, MI >50%, LVI, advanced stage and positive cytology correlated with shorter DFI and worse 3 year OS (p<0.5 respectively). Recurrence developed outside the abdomen in 56.5%. Patients with tumors with sarcomatous histology upon recurrence and predominant sarcomatous component in primary tumor (≥50%) had shorter DFI (p< 0.5%).
Conclusion UCs represent a distinct subtype of uterine malignancy, where, according to our data, LN metastasis, tumor size, MI, stage and sarcomatous (RMB in particular) component have a significant prognostic role.
Disclosure Nothing to disclose.
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