title: Malignant Mixed Müllerian Tumour of the Uterus: Analysis of 44 Cases.
abstract: OBJECTIVE
  The aim of our study was to evaluate the clinicopathological features and prognostic factors of uterine carcinosarcoma.
  
  
  METHODS
  In this retrospective study, the clinical characteristics of 44 patients with uterine MMMT were evaluated. Survival curves were estimated by the Kaplan-Meier method and compared by the log-rank test.
  
  
  RESULTS
  Forty-four patients with uterine carcinosarcoma were referred to our unit between 1995 and 2015. Their median age was 66.5 years. All women underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. Twenty-five percent had omental resection. Pelvic lymphadenectomy was performed in 18.2% of the cases. Twenty-six of the patients presented with stage I/II disease, 17 with advanced stages. In 20.5% of the cases there were metastases at diagnosis. Forty women received adjuvant chemotherapy, with complete remission in 67.9% of the cases. Recurrences were observed in 27.3% of the women. Disease-free and overall survival was 27 and 103 months, respectively. The FIGO stage, histological type, tumour size, chemotherapy regimen, pelvic lymphadenectomy, and myometrial invasion did not affect survival.
  
  
  CONCLUSIONS
  Uterine MMMT is an aggressive tumour, often diagnosed at an advanced stage and with a high rate of metastases or recurrences. Because of its rarity, its management is controversial and fixed prognostic factors cannot be defined.
authors.affiliation: Department of Biomedical Science and Human Oncology, Obstetrics and Gynecology Unit, University of Bari, Bari, Italy.
authors.forename: Silvana
authors.initials: S
authors.lastname: Grasso
authors.forename: Vera
authors.initials: V
authors.lastname: Loizzi
authors.forename: Valentina
authors.initials: V
authors.lastname: Minicucci
authors.forename: Leonardo
authors.initials: L
authors.lastname: Resta
authors.forename: Anna Lina
authors.initials: AL
authors.lastname: Camporeale
authors.forename: Ettore
authors.initials: E
authors.lastname: Cicinelli
authors.forename: Gennaro
authors.initials: G
authors.lastname: Cormio
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D002296:Carcinosarcoma / Q000401:mortality / Q000473:pathology / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision; D008875:Middle Aged; D018200:Mixed Tumor, Mullerian / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D010052:Ovariectomy / Q000379:methods; D012189:Retrospective Studies; D014594:Uterine Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*