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Original Research

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A retrospective study of clinicopathological characteristics, treatment, and outcomes of Chinese uterine and ovarian carcinosarcoma patients

  • Jun Zhu1,2
  • Hao Wen1,2
  • Rui Bi2
  • Xiaohua Wu1,2,*,

11Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Shanghai,China

2Department of Oncology, Shanghai Medical College, Fudan University, Shanghai,China

3Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai ,China

DOI: 10.12892/ejgo4043.2018 Vol.39,Issue 3,June 2018 pp.448-453

Published: 10 June 2018

*Corresponding Author(s): Xiaohua Wu E-mail:


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 (R 0 ) 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 R 0 for upfront treatment in CS patients.


Ovarian carcinosarcoma; uterine carcinosarcoma; prognostic factors; cytoreduction

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Jun Zhu,Hao Wen,Rui Bi,Xiaohua Wu. A retrospective study of clinicopathological characteristics, treatment, and outcomes of Chinese uterine and ovarian carcinosarcoma patients. European Journal of Gynaecological Oncology. 2018. 39(3);448-453.


[1] Kernochan L.E., Garcia R.L.: “Carcinosarcomas (malignant mixed Mul-lerian tumor) of the uterus: advances in elucidation of biologic andclinical characteristics”. J. Natl. Compr. Canc. Netw., 2009, 7, 550.

[2] Cimbaluk D., Rotmensch J., Scudiere J., Gown A., Bitterman P.: “Uterine carcinosarcoma: immunohistochemical studies on tissue microarrays with focus on potential therapeutic targets”. Gynecol. Oncol., 2007, 105, 138.

[3] Siegel R., Ward E., Brawley O., Jemal A.: “Cancer statistics, 2011: the impact of eliminating socioeconomic and racial disparities on premature cancer deaths”. CA Cancer J. Clin., 2011, 61, 212.

[4] Gadducci A., Sartori E., Landoni F., Zola P., Maggino T.,Cosio S., et al.: “The prognostic relevance of histological type in uterine sarcomas: a Cooperation Task Force (CTF) multivariate analysis of 249 cases”. Eur. J. Gynaecol. Oncol., 2002, 23, 295.

[5] Barnholtz-Sloan J.S., Morris R., Malone J.M. Jr., Munkarah A.R.: “Survival of women diagnosed with malignant, mixed mȕllerian tumors of the ovary (OMMMT)”. Gynecol. Oncol., 2004, 93, 506.

[6] Mano M.S., Rosa D.D., Azambuja E., Ismael G., Braga S., D’Hondt V., et al.: “Current management of ovarian carcinosarcoma”. Int. J. Gynecol. Cancer, 2007, 17, 316.

[7] Arend R., Doneza J.A., Wright J.D.: “Uterine carcinosarcoma”. Curr. Opin. Oncol., 2011, 23, 531.

[8] Mano M.S., Rosa D.D., Azambuja E., Ismael G., Braga S., D’Hondt V., et al.: “Current management of ovarian carcinosarcoma”. Int. J. Gynecol. Cancer, 2007, 17, 316.

[9] Rauh-Hain J.A., Diver E.J., Clemmer J.T., Bradford L.S., Clark R.M., Growdon W.B., et al.: “Carcinosarcoma of the ovary compared to papillary serous ovarian carcinoma: a SEER analysis”. Gynecol. Oncol., 2013, 131, 46.

[10] National Cancer Institute: Chapter 16 ovarian cancer” 2012. Available at:

[11] George E.M., Herzog T.J., Neugut A.I., Lu Y.S., Burke W.M., Lewin S.N., et al.: “Carcinosarcoma of the ovary: natural history, patterns of treatment, and outcome”. Gynecol. Oncol., 2013, 131, 42.

[12] Garg G., Shah J.P., Kumar S., Bryant C.S., Munkarah A., Morris RT..: “Ovarian and uterine carcinosarcomas: a comparative analysis of prognostic variables and survival outcomes”. Int. J. Gynecol. Cancer, 2010, 20, 888.

[13] Hellström A.C., Tegerstedt G., Silfverswärd C., Pettersson F.: “Malignant mixed mȕllerian tumors of the ovary: histopathologic and clinical review of 36 cases”. Int. J. Gynecol. Cancer, 1999, 9, 312.

[14] Ferguson S.E., Tornos C., Hummer A., Barakat R.R., Soslow R.A.: “Prognostic features of surgical stage I uterine carcinosarcoma”. Am. J. Surg. Pathol., 2007, 31, 1653.

[15] Harris M.A., Delap L.M., Sengupta P.S., Wilkinson P.M., Welch R.S., Swindell R., et al.: “Carcinosarcoma of the ovary”. Br. J. Cancer , 2003, 88, 654.

[16] Pacaut C., Bourmaud A., Rivoirard R., Moriceau G., Guy J.B., Collard O., et al.: “Uterine and ovary carcinosarcomas: outcome, prognosis factors, and adjuvant therapy”. Am. J. Clin. Oncol., 2015, 38, 272.

[17] Tanner E.J., Leitao M.M. Jr., Garg K., Chi D.S., Sonoda Y., Gardner G.J., et al.: “The role of cytoreductive surgery for newly diagnosed advanced-stage uterine carcinosarcoma”. Gynecol. Oncol., 2011, 123, 548.

[18] Doo D.W., Erickson B.K., Arend R.C., Conner M.G., Huh W.K., Leath C.A.: “Radical surgical cytoreduction in the treatment of ovarian carcinosarcoma”. Gynecol. Oncol., 2014, 133, 234.

[19]Wolfson A.H., Brady M.F., Rocereto T., Mannel R.S., Lee Y.C., Futoran R.J., et al.: “A gynecologic oncology group randomized phase III trial of whole abdominal irradiation (WAI) versus cisplatin-ifosfamide and mesna (CIM) as post-surgical therapy in stage I-IV carcinosarcoma (CS) of the uterus”. Gynecol. Oncol., 2007, 107, 177.

[20] Manolitsas T.P., Wain G.V., Williams K.E., Freidlander M., Hacker N.F.: “Multimodality therapy for patients with clinical stage I and II malignant mixed Müllerian tumors of the uterus”. Cancer, 2001, 91, 1437.

[21] Toyoshima M., Akahira J., Matsunaga G., Niikura H., Ito K., Yaegashi N., Tase T.: “Clinical experience with combination paclitaxel and carboplatin therapy for advanced or recurrent carcinosarcoma of the uterus”. Gynecol. Oncol., 2004, 94, 774.

[22] Leiser A.L., Chi D.S., Ishill N.M., New W.P.: “Carcinosarcoma of the ovary treated with platinum and taxane: the memorial Sloan-Kettering Cancer Center experience”. Gynecol. Oncol., 2007, 105, 657.

[23] Otsuki A., Watanabe Y., Nomura H., Futagami M., Yokoyama Y., Shibata K., et al.: “Paclitaxel and carboplatin in patients with completely or optimally resected carcinosarcoma of the uterus: a phase II trial by the Japanese Uterine Sarcoma Group and the Tohoku Gynecologic Cancer Unit”. Int. J. Gynecol. Cancer, 2015, 25, 92.

[24] Gungorduk K., Ozdemir A., Ertas I.E., Gokcu M., Telli E., Oge T., et al.: “Adjuvant treatment modalities, prognostic predictors and outcomes of uterine carcinosarcomas”. Cancer Res. Treat., 2015, 47, 282.

[25] Makker V., Abu-Rustum N.R., Alektiar K.M., Aghajanian C.A., Zhou Q., Iasonos A., et al.: “A retrospective assessment of outcomes of chemotherapy-based versus radiation-only adjuvant treatment for completely resected stage I-IV uterine carcinosarcoma”. Gynecol. Oncol., 2008, 111, 249.

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