902P - Ovarian Carcinosarcoma Management: a Retrospective Analysis of the Royal Marsden Experience

Abstract

ABSTRACT Aim: The optimal management of ovarian carcinosarcoma (OCS) is not established and prospective evidence is limited due to its rarity. The aim was to determine the effectiveness of treatment and explore potential factors predicting clinical outcome. Methods: A retrospective analysis of patients (pts) with OCS consecutively treated at The Royal Marsden Hospital between 2003 and 2012 was performed. Results: 66 pts were identified (mean age 65.3 years (42.4-86), FIGO stage III/IV at diagnosis 83%). 88% (58 pts) underwent surgery (41 primary, 17 interval) and optimal debulking was achieved in 65.5%. 94% (62 pts) received first line chemotherapy (38 adjuvant, 17 neoadjuvant, 7 without surgery). 3 pts had rapid progression resulting in death before chemotherapy. Platinum-based chemotherapy was used in 98% of pts. Radiological best response rate (RR) was 63%, with no significant difference between regimens (carboplatin/pegylated liposomal doxorubicin 67%, carboplatin/paclitaxel 60%, carboplatin 57%). 45 pts (73%) developed relapse/progression after first line chemotherapy (9 (20%) platinum-refractory, 23 (51%) platinum-resistant and 13 (29%) platinum-sensitive). 34 pts received further systemic treatment (radiological RR platinum-sensitive 42%, resistant 27%, refractory 0%). The median total number of systemic treatment lines from diagnosis was 2 (range 0-8). The median time from diagnosis to progression was 11.7 months (95%CI 10.1-13.5) for all patients and only 5.4 months for stage IV. In univariate analysis FIGO stage (p = 0.002), surgery (p Conclusions: OCS is a challenging disease. Clinical outcomes are poor compared to high grade serous carcinoma. Surgery and platinum-based chemotherapy are important management options for OCS. Rare cancers registries and randomised trials including OCS are needed to define optimal therapy. Disclosure: All authors have declared no conflicts of interest.