European Journal of Gynaecological Oncology (EJGO) is published by IMR Press from Volume 40 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.
This study aimed to determine the clinicopathological and prognostic factors, and to assess the impact of cytoreduction to complete gross resection in Chinese uterine and ovarian carcinosarcoma patients. Materials and Methods: The authors reviewed 86 consecutive patients treated for uterine (n=60) or ovarian (n=26) carcinosarcomas between February 2006 and August 2013 at Fudan University Shanghai Cancer Center. Results: The median follow-up time was 24.0 months [interquartile range (IQR): 12.4 to 48.7]. The median age was 59 years (IQR: 53 to 66). The three- and five-year overall survival rates were 60.1% and 42.8%, respectively. Extent of tumor dissemination, mesenchymal component, and adjuvant therapy were predictive of overall survival. Among advanced carcinosarcoma patients, complete gross resection (R0) had a three-year overall survival rate of 52.5%, vs. 38.9% and 20.8% in patients with gross residual disease ≤ 1cm and > 1cm (p = 0.004). On multivariate analysis, only heterologous mesenchymal component (HR=4.8; 95% CI, 1.4-16.7; p = 0.015) and gross residual disease (HR=2.6, 95% CI: 1.2-5.9; p = 0.019) were predictors of increased mortality. Conclusions: Heterologous tumor and incomplete gross resection were significantly predictive of a poor overall survival in carcinosarcoma patients. We recommend cytoreduction to R0 for upfront treatment in CS patients.