title: Carcinosarcoma of the ovary compared to papillary serous ovarian carcinoma: a SEER analysis.
abstract: OBJECTIVE
  The aims of this study are to determine if outcomes of patients with ovarian carcinosarcoma (OCS) differ from women with high grade papillary serous ovarian carcinoma when compared by stage as well as to identify any associated clinico-pathologic factors.
  
  
  METHODS
  The Surveillance, Epidemiology, and End Results (SEER) Program data for all 18 registries from 1998 to 2009 was reviewed to identify women with OCS and high grade papillary serous carcinoma of the ovary. Demographic and clinical data were compared, and the impact of tumor histology on survival was analyzed using the Kaplan-Meier method. Factors predictive of outcome were compared using the Cox proportional hazard model.
  
  
  RESULTS
  The final study group consisted of 14,753 women. 1334 (9.04%) had OCS and 13,419 (90.96%) had high grade papillary serous carcinoma of the ovary. Overall, women with OCS had a worse five-year, disease specific survival rate, 28.2% vs. 38.4% (P<0.001). This difference persisted for each FIGO disease stages I-IV, with five year survival consistently worse for women with OCS compared with papillary serous carcinoma. Over the entire study period, after adjusting for histology, age, period of diagnosis, SEER registry, marital status, stage, surgery, radiotherapy, lymph node dissection, and history of secondary malignancy after the diagnosis of ovarian cancer, carcinosarcoma histology was associated with decreased cancer-specific survival.
  
  
  CONCLUSIONS
  OCS is associated with a poor prognosis compared to high grade papillary serous carcinoma of the ovary. This difference was noted across all FIGO stages.
authors.affiliation: Division of Gynecologic Oncology, Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: J Alejandro
authors.initials: JA
authors.lastname: Rauh-Hain
authors.forename: Elisabeth J
authors.initials: EJ
authors.lastname: Diver
authors.forename: Joel T
authors.initials: JT
authors.lastname: Clemmer
authors.forename: Leslie S
authors.initials: LS
authors.lastname: Bradford
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Clark
authors.forename: Whitfield B
authors.initials: WB
authors.lastname: Growdon
authors.forename: A K
authors.initials: AK
authors.lastname: Goodman
authors.forename: David M
authors.initials: DM
authors.lastname: Boruta
authors.forename: John O
authors.initials: JO
authors.lastname: Schorge
authors.forename: Marcela G
authors.initials: MG
authors.lastname: del Carmen
mesh_terms: D000367:Age Factors; D000368:Aged; D002291:Carcinoma, Papillary / Q000401:mortality* / Q000473:pathology*; D002296:Carcinosarcoma / Q000401:mortality* / Q000473:pathology*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000401:mortality* / Q000473:pathology*; D016016:Proportional Hazards Models; D018426:SEER Program; D015996:Survival Rate; D014481:United States / Q000453:epidemiology
keywords: High grade papillary serous ovarian cancer; Ovarian carcinosarcoma