Uterine Carcinosarcoma: A Single Centre Retrospective Clinical Cohort Analysis

Objective: Carcinosarcomas are rare, heterogeneous tumours with a poor prognosis and no well-defined treatment pathway. Through analysis of a cohort of University College London Hospital (UCLH) patients, we assessed potential known clinicopathological prognostic factors by looking at the association of baseline characteristics with progression free survival (PFS) and overall survival (OS). Methods: Women with uterine carcinosarcoma treated at UCLH from 2003 to 2014 were retrospectively identified and analysed. Clinicopathological data and treatment history were collected from patient records. Results: 73 patients were included. 69.9% were FIGO stage I/II, 62.2% had heterologous elements and 60.0% had lymphovascular space invasion (LVSI). Adjuvant chemotherapy and radiotherapy (RT) was received by 48% of patients, 27.4% had RT alone and 8.2%, chemotherapy alone. Median OS was 38.3 months and PFS 25.5 months. Two-year OS and PFS were greater in earlier stage disease (OS; 68.3% vs. 48.9%, PFS; 58.7% vs. 36.1%), homologous component (OS; 72.7% vs. 41.7%, PFS; 60.8% vs. 35.7%) and absence of LVSI (OS; 75.3% vs. 53.7%, PFS; 66.9% vs. 42.5%). Two years OS and PFS for patients who received adjuvant chemotherapy and RT was 64.9% and 58.2% respectively, which was similar to survival rate of those who received RT alone (OS 68.4% and PFS 57.4%). Patients who didn’t receive adjuvant treatment had worse survival (32.7% OS and 11.4% PFS). Conclusions: Patients receiving RT alone had similar survival to those receiving RT and chemotherapy. Patients who didn’t receive adjuvant treatment had the poorest survival.