title: Uterine and ovary carcinosarcomas: outcome, prognosis factors, and adjuvant therapy.
abstract: OBJECTIVE
  The aim of this study was to assess the outcome and the prognosis factors of uterine and ovarian carcinosarcomas.
  
  
  METHODS
  From January 1993 to January 2010, data from 68 consecutively treated patients with uterine (n=59) and ovarian (n=9) carcinosarcomas were retrospectively analyzed in a single French comprehensive cancer center.
  
  
  RESULTS
  The median follow-up was 24.2 months (interquartile range [IQR]: 13.5 to 54.6). The median age was 69 years (IQR: 63 to 77). Patients were classified as FIGO stage I (n=28; 41%) and FIGO stage II to IV (n=40; 59%), respectively. There were 33 (49%) and 29 (43%) homologous and heterologous type, respectively. The median disease-free survival and overall survival were 21.9 months (IQR: 7.9 to 22.3) and 27.1 months (IQR: 14.5 to 72), respectively. No statistical differences of survival were reported concerning the initial location of the carcinosarcoma (uterine vs. ovarian). Radiation therapy (hazards ratio [HR]=0.3; 95% confidence interval [CI], 0.16-0.67) and FIGO stage I (HR=0.4; 95% CI, 0.17-0.9) were associated with an increased disease-free survival. Homologous type (HR=3; 95% CI, 1.4-6.3) and FIGO stage II to IV (HR=2.64; 95% CI, 1.3-5.4) were associated with a decreased overall survival. There was no survival improvement for the 12% of patients receiving a multimodal adjuvant therapy.
  
  
  CONCLUSIONS
  Uterine and ovary carcinosarcomas present a worse prognosis. On the basis of the present study data, although it should be prospectively confirmed, a sequential or multimodal adjuvant therapy should be proposed to patients with early-stage uterine and ovary carcinosarcomas.
authors.affiliation: *Département d'Oncologie Médicale †Département de Santé Publique ‡Département de Radiothérapie, Institut de Cancérologie Lucien Neuwirth §Département d'Oncologie Radiothérapie, Institut Gustave Roussy, Université Paris Sud, Paris ∥Service de Chirurgie Gynécologique, CHU Nord de Saint-Etienne, Saint Etienne, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Pacaut
authors.forename: Aurélie
authors.initials: A
authors.lastname: Bourmaud
authors.forename: Romain
authors.initials: R
authors.lastname: Rivoirard
authors.forename: Guillaume
authors.initials: G
authors.lastname: Moriceau
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Guy
authors.forename: Olivier
authors.initials: O
authors.lastname: Collard
authors.forename: Claire
authors.initials: C
authors.lastname: Bosacki
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Jacquin
authors.forename: Antonin
authors.initials: A
authors.lastname: Levy
authors.forename: Céline
authors.initials: C
authors.lastname: Chauleur
authors.forename: Nicolas
authors.initials: N
authors.lastname: Magné
authors.forename: Yacine
authors.initials: Y
authors.lastname: Merrouche
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002296:Carcinosarcoma / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D059186:Chemoradiotherapy, Adjuvant; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D008197:Lymph Node Excision; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D010052:Ovariectomy; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D058994:Salpingectomy; D015996:Survival Rate; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*