Clinicopathological features of ovarian carcinosarcomas: a single institution experience.
OBJECTIVE
The aim of this study was to elucidate the clinicopathological and immunohistochemical prognostic factors of patients with ovarian carcinosarcoma treated with radical surgery and postoperative chemotherapy.


METHODS
During a 6-year period, nine patients with ovarian carcinosarcoma were referred to our institution. Tissue blocks were reviewed and sections containing both carcinomatous and sarcomatous elements were stained for epithelial membrane antigen (EMA), vimentin, vascular endothelial growth factor (VEGF), CD45RO, c-erbB-2, p53, CD34, Ki67, S100, estrogen, and progesterone receptors. Histological and immunohistochemical findings as well as clinical characteristics were then correlated with progression-free interval and overall survival.


RESULTS
There were four homologous and five heterologous carcinosarcomas. Five patients had early stage disease. Seven of the patients were optimally debulked. All patients were treated with anthracycline-based chemotherapy following surgery. With regard to immunohistochemistry, all specimens were negative for CD34, c-erbB-2, estrogen, and progesterone receptor expression. Five tumors overexpressed p53 and four specimens demonstrated a positive staining for Ki67. Reactivity for VEGF and CD45RO was observed in four and two tumor specimens, respectively. The median overall survival was 32.9 months with no statistical difference between early and advanced stages, while median time to progression was 13.5 months. p53 overexpression demonstrated a trend for better overall survival.


CONCLUSIONS
Only p53 overexpression seems to influence overall survival although, due to the small number of patients studied, no safe conclusions can be drawn. Despite the predominance of early stage patients that favorably influenced overall survival, aggressive surgical cytoreduction followed by anthracycline-based treatment were the cornerstone in our multimodality approach.
Zorzou
Markella-P
MP
Department of Clinical Therapeutics, Alexandra Hospital, University of Athens, School of Medicine, 14671 Nea Erythrea, Athens, Greece.
Markaki
Sophia
S
Rodolakis
Alexandros
A
Kastritis
Efstathios
E
Bozas
Georgios
G
Dimopoulos
Meletios A
MA
Papadimitriou
Christos A
CA
D000368:Aged; D018943:Anthracyclines / Q000627:therapeutic use; D002296:Carcinosarcoma / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000378:metabolism; D017493:Leukocyte Common Antigens / Q000378:metabolism; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D009418:S100 Proteins / Q000378:metabolism; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism
D018943:Anthracyclines; D019394:Ki-67 Antigen; D009418:S100 Proteins; D042461:Vascular Endothelial Growth Factor A; D017493:Leukocyte Common Antigens