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Carcinosarcoma of the uterus: A comparison of adjuvant therapy and outcome
Author(s) -
WONG Lisa,
SEE Hui Ti,
KHOOTAN Hoon Seng,
LOW John,
FOOKCHONG Stephanie,
LOW Jeffrey,
TAY Sun Kuie
Publication year - 2006
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/j.1743-7563.2006.00037.x
Subject(s) - medicine , carcinosarcoma , radiation therapy , carboplatin , endometrial cancer , proportional hazards model , adjuvant therapy , chemotherapy , surgery , uterine cancer , stage (stratigraphy) , ifosfamide , oncology , cancer , cisplatin , carcinoma , biology , paleontology
Background: Uterine carcinosarcoma are rare and aggressive tumors. There is no consensus on the appropriate adjuvant therapy. Our aim is to compare the clinical outcome and role of adjuvant chemotherapy and radiotherapy in women with uterine carcinosarcoma. Methods: A retrospective review was carried out from 1995 to 2004 to obtain data on overall and disease‐free survival. The Kaplan‐Meier method and the log rank test was used to compare the survival by treatment given and the Cox proportional hazard regression model was used to adjust for age and stage. Results: Sixty‐six patients were identified. The median age was 60 years. 4 women did not undergo surgical staging and they were excluded. 32 (52%) patients received adjuvant chemotherapy with a combination of paclitaxel and carboplatin or cisplatin and ifosfamide. 36 (58%) patients received adjuvant radiotherapy. 23 patients (35%) had combined adjuvant chemotherapy and radiotherapy. Using the Cox regression model to adjust for age and stage of disease, patients who received multimodality treatment had improved survival compared to patients who had surgery only. ( P = 0.001, HR = 9.0, 90% C.I. = 3.2, 25.4). Tumour recurrence occurred in 23 patients at a median duration of 10 months. The median survival was 53 months. The overall 5‐year survival was 53.2%. Conclusion: Surgery remains the mainstay of treatment for carcinosarcoma of the uterus. Our results suggest that patients who had multimodality adjuvant therapy with chemotherapy and radiotherapy had improved survival. Future treatment strategies should incorporate multimodality adjuvant chemotherapy and radiotherapy to provide local as well as distant control.