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Abstract
Introduction Patients with uterine carcinosarcoma (UCS) have a dismal prognosis despite receiving extensive treatment which also may abate the quality of life (QoL). Our aim is to determine the survival in patients with UCS and to assess the QoL during and after treatment.
Methods An observational study was performed in the Erasmus Medical center between 2016 – 2021, including all patients with UCS. Clinical data was collected from diagnosis until 5 years after treatment or death. EORTC QLQ-C30 and -EN24 were obtained at four time points: pre-operative, end of treatment (ET), one year, and two year after treatment. QLQ-C30 outcomes were also compared with normative data of a matching reference group.
Results 52 patients were included in the study, with a mean age of 69 years (range 50–86 years) at the time of diagnosis. The majority of patients were diagnosed with early-stage disease (N=20, N=5, N=9, N=18 patients respectively with FIGO stage I-IV). Median overall survival (OS) was 18 months, with the poorest survival seen in patients with stage IV disease (median OS=9 months) (figure 1). QoL assessment indicated that patients with advanced stage disease reported significantly more deterioration on insomnia, financial problems, tingling/numbness and hair loss. Furthermore, comparing QLQ-C30 outcomes at ET showed a significant difference compared to normative data in overall quality of life, role, emotional, cognitive and social functioning (figure 2).
Conclusion/Implications Patients with UCS face a poor prognosis, and the effect of treatment on QoL be considered in clinical decision-making, particularly in patients with advanced stage disease.
Kaplan-Meier curve for overall survival (OS) among patients with FIGO stage I, II, III and IV UCS. Patients who were lost to follow up or alive at end of follow up are censored
A)Mean scores of total study population at four time points of selected domains of EQRTC-QLQ-C30: quality of life overall score and role, emotional, cognitive, and social functioning. These domains were statistically different compared to normative data of a matched reference group (women from 60–69 years) which was respectively 76.5, 83.8, 85.9, 91.3 and 91.3 (not depicted). For these domains, a higher score equals a higher quality of life. B) Mean scores of total study population at four time points of selected domains of EQRTC-QLQ-C30 and QLQ-EN-24: Tingling/numbers, hairloss, insomnia and financial problems. These domains were statistically more affected at advanced stage disease (not seperatly depicted). For these domains, a lower score equals a higher quality of life. Data of patients who were deceased at later timepoints were not included in the analysis