Introduction/Background The relevance of cell cycle regulatory markers with uterine carcinosarcoma was investigated.

Methodology The immunohistochemical expression of p16, p53, and cyclin D1 were assessed using tissue microarray of 55 eligible patients.

Results p16 and p53 showed a high rate of strong (+3) immune reaction in carcinomatous/sarcomatous components (61.8%/70.9% and 52.7%/56.4%, respectively). Cyclin D1 showed a 14.5%/7.3% of strong immune reaction in the carcinomatous/sarcomatous components. Strong expression of p16 was related to a higher rate of lymph node metastasis and a bigger tumor size. Strong expression of cyclin D1 was related to the lower International Federation of Gynecology and Obstetrics (FIGO) stage. In univariate regression analysis, FIGO stage, lymph node metastasis, p16, and cyclin D1 were prognostic factors for disease-free survival. FIGO stage, p16, p53, and cyclin D1 were prognostic factors for overall survival. In a multivariate regression analysis, FIGO stage and p16 in carcinomatous component were independent factors for both disease-free survival (odds ratio [OR], 95% confidence interval [CI]; 3.5 [1.2–10.3] and 3.5 [1.3–9.9]; P = 0.026 and 0.016) and overall survival (OR, 95% CI; 2.3 [1.0–5.1] and 2.9 [1.1–7.8]; P = 0.042 and 0.037).

Conclusion p16 was a predictor of lymph node metastasis, tumor size, and prognostic outcome in uterine carcinosarcoma.