Article Text
Abstract
Introduction Uterine carcinosarcoma (UCS) is a rare and aggressive malignancy excluded from The Cancer Genome Atlas (TCGA). We identify demographics, molecular classifications and next generation sequencing information in this population.
Methods This retrospective chart review identified patients diagnosed with UCS from 2017-2022 at two hospital systems in New York City through the tumor registry. Demographic data and clinicopathologic data were collected. Mismatch repair (MMR) deficiency was determined by immunohistochemistry (IHC) or microsatellite instability (MSI) high on next generation sequencing (NGS). Similarly, p53 expression was collected. Using the ProMisE algorithm, patients were separated into TCGA molecular classifications and descriptive analysis completed.
Results We identified 111 patients with pathology-confirmed UCS. The median age at treatment was 67 (IQR 61-73) and median BMI was 27.9 (IQR 23.2-35.3). Thirty-five percent (n=40) identified as Non-Hispanic White, 44% (n=50) as Non-Hispanic Black, 12% (n=14) as Hispanic, 4% (n=5) as Asian and 2% (n=2) as other. Forty-one percent (n=45) were classified into TCGA groups with 15.6% (n=7) MMR-deficient (dMMR) 2.1% (n=1) POLE mutation, 10.6% (n=5) p53 wild-type, and the majority, 68.1% (n=32) p53 aberrant. Eighty-nine% (n=99) had MMR IHC information, 67% (n=74) had IHC p53 information and 36% (n=40) had NGS. The most common genomic mutation was TP53 (80%, n=32), followed by FBXW7 (30%, n=12) and MSH2 (28%, n=11).
Conclusion/Implications In this diverse population, 40% were able to be classified and most were p53 aberrant, which is associated with poorer prognosis in TCGA classifications. We build upon limited existing data and advocate for further molecular information in this patient population.