title: The effect of chemotherapy on the different components of advanced carcinosarcomas (malignant mixed mesodermal tumors) of the female genital tract.
abstract: The effect of chemotherapy on the different components of uterine and ovarian carcinosarcoma is largely unknown. This report describes six patients with advanced carcinosarcoma, five of whom received 4 cycles of doxorubicin and ifosfamide (AI) directed at the sarcomatous component of the tumor. Responses in these five patients at second-look laparotomy were: one complete response, two partial responses (persistence of only the carcinomatous component), one stable disease, and one progressive disease (both components still present in both cases). Thereafter 4 cycles of a cisplatin-based regimen were scheduled. Response to the cisplatin-containing regimen was only evaluated clinically. The sixth patient (with no macroscopic disease left after initial surgery) received 6 cycles of a cisplatin-based chemotherapy from the onset and was found to be in complete response at relaparotomy. Median progression-free survival for all patients was 15 months and median survival 21 months. A literature survey showed that carcinosarcoma differs from adult soft tissue sarcomas with respect to responsiveness to chemotherapy. Cisplatin and ifosfamide are active as single agents, whereas the response to single-agent doxorubicin seems to be lower. The data suggest, however, that superior response rates and increased survival times are achieved with cisplatin/doxorubicin-based chemotherapy. The sensitivity of carcinosarcoma to cisplatin supports the recent view that carcinosarcoma of the female genital tract is possibly a high grade carcinoma with metaplastic sarcomatous elements.
authors.affiliation: Departments of Medical Oncology, Gynecology, and Pathology, Free University Hospital, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
authors.forename: R.E.N.
authors.initials: RE
authors.lastname: van Rijswijk
authors.forename: G.
authors.initials: G
authors.lastname: Tognon
authors.forename: C.W.
authors.initials: CW
authors.lastname: Burger
authors.forename: J.P.
authors.initials: JP
authors.lastname: Baak
authors.forename: P.
authors.initials: P
authors.lastname: Kenemans
authors.forename: J.B.
authors.initials: JB
authors.lastname: Vermorken