title: Carcinosarcoma of the ovary-a case series.
abstract: OBJECTIVE
  To evaluate our experience with ovarian carcinosarcoma and identify prognostic factors.
  
  
  METHODS
  Thirty-one cases of ovarian carcinosarcoma were identified over a 6-year time period through tumor registry and pathology records. Fisher exact test and log rank using Kaplan-Meier method (P < 0.05) were used to compare variables with outcome.
  
  
  RESULTS
  All 31 patients underwent initial surgical treatment with an appropriate staging procedure. Stage distribution: 1 stage I, 6 stage II, 23 stage III, and 1 stage IV. The median follow-up was 28 months. The median survival for the entire group was 21 months. Early vs. advanced stage significantly influenced progression-free interval, P = 0.05. Nineteen patients were found to have stage IIIC disease and required debulking procedures. In patients with stage IIIC disease, presence of residual disease was associated with decreased overall survival, P = 0.03. 29 patients received adjuvant chemotherapy with 11 patients receiving ifosfamide/cisplatin and 16 patients receiving carboplatin/taxol. Progression-free interval was improved with the use of ifosfamide/cisplatin vs. carboplatin/taxol. The median PFI was 12 months in the carbo/taxol group and has not been reached in the ifos/cisplatin group (P = 0.005). The overall survival was also significantly improved with the use of ifosfamide/cisplatin, P = 0.03. In advanced stage patients, overall survival was not significantly influenced by type of adjuvant chemotherapy administered, P = 0.13.
  
  
  CONCLUSIONS
  Ovarian carcinosarcoma has a poor overall prognosis with median survival rates reported in the literature ranging from 7-10 months. Our series, although limited by a small number of patients, exhibits a more encouraging median survival of 21 months for the overall group. Aggressive debulking to eliminate residual disease and the use of ifosfamide/cisplatin chemotherapy seem to be factors in this improved outcome.
authors.affiliation: University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA. teresa_rutledge@med.unc.edu
authors.forename: Teresa L
authors.initials: TL
authors.lastname: Rutledge
authors.forename: Michael A
authors.initials: MA
authors.lastname: Gold
authors.forename: D Scott
authors.initials: DS
authors.lastname: McMeekin
authors.forename: Warner K
authors.initials: WK
authors.lastname: Huh
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Powell
authors.forename: Sharyn N
authors.initials: SN
authors.lastname: Lewin
authors.forename: David G
authors.initials: DG
authors.lastname: Mutch
authors.forename: Gary A
authors.initials: GA
authors.lastname: Johnson
authors.forename: Joan L
authors.initials: JL
authors.lastname: Walker
authors.forename: Robert S
authors.initials: RS
authors.lastname: Mannel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D002296:Carcinosarcoma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D017239:Paclitaxel / Q000008:administration & dosage; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D004317:Doxorubicin; D016190:Carboplatin; D017239:Paclitaxel; D002945:Cisplatin; D007069:Ifosfamide