Introduction/Background The aim of our study was to evaluate the clinicopathological features and prognostic factors of uterine mixed muller malignant tumor (MMMT).

Methodology In this retrospective study, the clinical characteristics patients with uterine MMMT were evaluated. Survival curves were estimated by the Kaplan-Meier method and compared by the log-rank est.

Results Eighty patients with uterine carcinosarcoma were referred at University of Bari between 1995 and 2022. Their median age was 66.5 years. All women underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. Twenty-five percent had also omental resection. Pelvic lymphadenectomy was performed in 18% of the cases. The distribution by FIGO stage showed 21% in stage I (8% in stage IA and 13% in stage in stage IB), 35% in in stage II, 35% in stage III and 9% in stage IV. Adjuvant chemotherapy was administered to 54 patients (67%). Disease recurrence was observed in 26 cases (32%). The disease-free interval, defined as the time interval between the end of the first line of chemotherapy and the appearance of recurrence or distant metastases, was 23 months. The median overall survival was 103 months.

The evaluation of survival according to FIGO stage, histological type, tumour size, chemotherapy regimen, pelvic lymphadenectomy, and myometrial invasion provided results not statistically significant for prognostic purposes. However, no statistical differences were observed after adjusting for FIGO stage. Only tumour histotype was found to be a decisive element for prognostic evaluation after adjusting for stage: patients with homologous-type MMMT demonstrated a survival advantage in an advanced stage compared to an early stage.

Conclusion Uterine MMMT is an aggressive tumour, often diagnosed at an advanced stage and with a high rate of metastases or recurrences. Because of its rarity, its management is controversial and fixed prognostic factors cannot be defined.

Disclosures No discosure