title: Adjuvant treatment modalities, prognostic predictors and outcomes of uterine carcinosarcomas.
abstract: OBJECTIVE
  The purpose of this study is to evaluate the clinicopathological characteristics, treatment, and prognosis of uterine carcinosarcoma (UC).
  
  
  METHODS
  A retrospective review of three cancer registry databases in Turkey was conducted for identification of patients diagnosed with UC between January 1, 1996, and December 31, 2012. We collected clinicopathological data in order to evaluate factors important in disease- free survival (DFS) and overall survival (OS).
  
  
  RESULTS
  A total of 66 patients with UC with a median age of 65.0 years were included in the analysis. The median survival time of all patients was 37.5 months and the 5-year OS rate was 59.1%. In early stage patients (I-II) who received adjuvant chemotherapy (CT) with radiation therapy (RT), the median DFS and OS was 44 months and 55 months, respectively, compared to 34.5 months and 36 months, respectively, in patients who received adjuvant RT or CT alone (hazard ratio [HR], 1.4; 95% confidence interval [CI], 0.7 to 3.1 for DFS; p=0.23 and HR, 2.2; 95% CI, 0.9 to 5.3 for OS; p=0.03). In advanced stage patients (III-IV), the median DFS and OS of patients receiving adjuvant RT with CT was 25 months and 38 months, respectively, compared to 23.5 months and 24.5 months, respectively, in patients receiving adjuvant RT or CT alone (HR, 3.1; 95% CI, 0.6 to 16.0 for DFS; p=0.03); (HR, 3.3; 95% CI, 0.7 to 15.0 for OS; p=0.01). In multivariate analysis, advanced International Federation of Gynecology and Obstetrics (FIGO) stage and suboptimal surgery showed significant association with poor OS.
  
  
  CONCLUSIONS
  In patients with early or advanced stage UC, adjuvant CT with RT is associated with improved DFS and OS, as compared to CT or RT alone.
authors.affiliation: Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey.
authors.forename: Kemal
authors.initials: K
authors.lastname: Gungorduk
authors.affiliation: Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey.
authors.forename: Aykut
authors.initials: A
authors.lastname: Ozdemir
authors.affiliation: Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey.
authors.forename: Ibrahim E
authors.initials: IE
authors.lastname: Ertas
authors.affiliation: Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Gokcu
authors.affiliation: Department of Gynecologic Oncology, Osmangazi University School of Medicine, Eskisehir, Turkey.
authors.forename: Elcin
authors.initials: E
authors.lastname: Telli
authors.affiliation: Department of Gynecologic Oncology, Osmangazi University School of Medicine, Eskisehir, Turkey.
authors.forename: Tufan
authors.initials: T
authors.lastname: Oge
authors.affiliation: Department of Gynecologic Oncology, Bulent Ecevit University School of Medicine, Zonguldak, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Sahbaz
authors.affiliation: Department of Pathology, Tepecik Education and Research Hospital, Izmir, Turkey.
authors.forename: Sevil
authors.initials: S
authors.lastname: Sayhan
authors.affiliation: Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey.
authors.forename: Muzaffer
authors.initials: M
authors.lastname: Sanci
authors.affiliation: Department of Gynecologic Oncology, Bulent Ecevit University School of Medicine, Zonguldak, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Harma
authors.affiliation: Department of Gynecologic Oncology, Osmangazi University School of Medicine, Eskisehir, Turkey.
authors.forename: Sinan
authors.initials: S
authors.lastname: Ozalp
keywords: Adjuvant chemotherapy; Adjuvant radiotherapy; Carcinosarcoma; Uterine neoplasms