Introduction/Background*Uterine Carcinosarcoma (UCS) comprises <5% of uterine malignancies, accounting for >15% associated mortality. With no established guidelines, we present our experience to determine optimal treatment and prognosis of UCS.

Methodology We conducted a multicentre retrospective cohort study, including all surgically managed UCS cases between March 2010 and January 2020. Data was collected on FIGO staging and post-operative management, recurrence and survival outcomes.

Result(s)*82 (9.7%) UCS cases were identified. Table 1 demonstrates case staging and management strategies. 23 patients underwent surgery alone due to poor performance status, comorbidities, age or treatment refusal. 15.8% had lymph nodes metastases, which was in keeping with the literature. Recurrence occurred in 47.8% and 77.8% of cases of early and late stage respectively; most frequently in the pelvis, but also commonly in the pelvic lymph nodes and chest. Both recurrence and subsequent death usually occurred within the first 1-2 years following treatment. This retrospective analysis explores for significance in overall and disease free survival between disease stage groups and treatment modalities using univariable and multivariable Cox regression models and Kaplan-Meier curves.

Conclusion*UCS is highly aggressive and has a poor prognosis. Significant rates of lymph node metastases have implications for adjuvant treatment in addition to high rates of relapse and distant metastases. Without an optimal treatment strategy established, discussions continue regarding adjuvant management as to potential improvements in prognosis. Whilst surgery remains the mainstay, multimodal treatment plans including combination of systemic chemotherapy followed by vaginal brachytherapy may be reasonable to address risks of both local relapse and distant metastases. In view of limited data and few prospective trials, we report on the results of our cancer network in contribution to evaluation of results of care in building a consensus for case management. We stress the importance of an individualised multidisciplinary team approach for management of UCS.