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Prognostic factors in uterine carcinosarcoma
Author(s) -
Iwasa Yoko,
Haga Hironori,
Konishi Ikuo,
Kobashi Yoichiro,
Higuchi Kayoko,
Katsuyama Eiji,
Minamiguchi Sachiko,
Yamabe Hirohiko
Publication year - 1998
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19980201)82:3<512::aid-cncr13>3.0.co;2-4
Subject(s) - carcinosarcoma , medicine , univariate analysis , stage (stratigraphy) , pathology , neoplasm , adenocarcinoma , immunohistochemistry , oncology , cancer , carcinoma , multivariate analysis , biology , paleontology
BACKGROUND Carcinosarcoma (malignant mixed mullerian tumor) of the female genital tract is a highly malignant neoplasm. The tumor stage and histologic grade of the carcinomatous component are among the important prognostic indicators cited in the literature for this tumor. METHODS Twenty‐five patients with uterine carcinosarcoma at 4 hospitals in the Kyoto and Nara areas of Japan were studied retrospectively. The clinicopathologic and immunohistochemical data including p53, bcl‐2, Ki‐67, and proliferating cell nuclear antigen (PCNA) staining were analyzed using univariate and multivariate analysis with the Cox proportional hazards model to investigate potential prognostic indicators for this neoplasm. RESULTS The 5‐year survival rate was 36.4% for all stages, 62.3% for Stage I, and 0% for Stages II‐IV. From the univariate analysis, stage ( P = 0.0001), endometrioid adenocarcinoma as a carcinomatous component ( P = 0.0006), age ( P = 0.0355), and a heterologous sarcomatous component ( P = 0.0421) were found to be prognostically significant for patient survival. Stage was the only independent significant factor in the multivariate analysis (t = 2.212). None of the other factors (history of pregnancy and gestation, gross appearance of the tumors, grade of the carcinomatous component, mitotic count of the sarcomatous component, Ki‐67 and PCNA reactivity, or p53 or bcl‐2 positive staining) was found to be a significant prognostic indicator. CONCLUSIONS Stage appears to be the only definite independent prognostic indicator of survival in patients with uterine carcinosarcoma. It is uncertain whether age, endometrioid adenocarcinoma as a carcinomatous component, or absence of a heterologous component in the sarcomatous area are prognostic factors. Immunohistochemical expression of p53, bcl‐2, Ki‐67, or PCNA is not a prognostic indicator. The immunohistochemical results of the current study may support the hypothesis of a common stem cell origin of this tumor. Cancer 1998;82:512‐9. © 1998 American Cancer Society.