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Uterine carcinosarcoma: A 10-year single institution experience
Leana Terblanche1, Matthys H Botha1
1Department of Obstetrics and Gynaecology and Unit for Gynaecological Oncology, Tygerberg Hospital, Stellenbosch University, Cape Town, South Africa.
Plos One
|July 21, 2022
Summary
Uterine carcinosarcoma patients in South Africa had significantly poorer 5-year survival rates (17.3% PFS, 19.7% OS) compared to other cohorts. Full staging surgery and multimodal treatments improved survival outcomes for this aggressive cancer.
Area of Science:
- Gynecologic Oncology
- Pathology
- Epidemiology
Background:
- Uterine carcinosarcoma is an aggressive malignancy with limited data on prognostic factors and survival outcomes in certain populations.
- Understanding recurrence patterns and survival is crucial for improving patient management.
Purpose of the Study:
- To determine 5-year progression-free survival (PFS) and overall survival (OS) in uterine carcinosarcoma patients.
- To identify clinical and surgical-pathologic features associated with survival.
- To recognize recurrence patterns and prognostic factors.
Main Methods:
- Retrospective review of 61 patients with pathologically confirmed uterine carcinosarcoma treated at a single institution over 10 years.
- Kaplan-Meier survival analysis and Cox proportional hazards models were used to analyze data.
Main Results:
- Five-year PFS was 17.3% and 5-year OS was 19.7%.
- Tumor diameter ≥ 100mm was associated with shorter PFS.
- Positive family history, full staging operation, and other treatment modalities were associated with better OS.
- Advanced stage, residual tumor, and myometrial/cervical/adnexal invasion were associated with higher mortality risk.
Conclusions:
- This cohort exhibited poorer survival than contemporary cohorts, possibly due to biological or genetic factors, later diagnosis, or limited healthcare access.
- Recurrences predominantly occurred outside the pelvis.
- Full staging surgery and multimodal treatment approaches significantly improve survival outcomes.
