Sarcoma regimens for gynecologic carcinosarcoma: Is there a benefit? (186)

Abstract

<b>Objectives:</b> To compare differences in overall survival (OS) in patients with carcinosarcomas of endometrial or ovarian origin who were ever treated with sarcoma chemotherapy regimens compared to those who only received traditional carcinoma regimens. <b>Methods:</b> We conducted a single-institution, retrospective cohort study of patients with a confirmed histologic diagnosis of uterine or ovarian carcinosarcoma diagnosed since the year 2000. Clinical, pathology, and outcomes data were collected. Patients were considered to have received a sarcoma-based regimen if any of their treatment courses included ifosfamide, combination gemcitabine/ docetaxel, or any other regimens listed on the NCCN guidelines for soft tissue sarcomas. Clinical and demographic characteristics were compared across groups using Chi-square, Fisher's exact, or Wilcoxon rank-sum tests. OS was evaluated using a log-rank test. <b>Results:</b> A total of 88 patients with carcinosarcoma of endometrial (77%) or ovarian (22%) origin were identified, 78 of whom had chemotherapy information available. Sixteen (23%) of the patients received chemotherapy that included a sarcoma regimen, 51 (65%) received only carcinoma regimens, and 13 (16%) did not receive any chemotherapy. We excluded ten patients for whom there was no chemotherapy information from the analysis. Among those who received any chemotherapy, there were no significant differences in age, BMI, race, use of radiation, number of lines of chemotherapy received, disease stage, or optimal cytoreduction rate between the two regimen groups. Patients were more likely to have an endometrial primary if they ever received a sarcoma regimen (Table 1). There was no difference in OS between the sarcoma regimen and non-sarcoma regimen groups (HR: 0.71, 95% CI: 0.30-1.64). Older age, stage IV disease, and suboptimal debulking status were associated with shorter OS in this group of patients (p<0.05). <b>Conclusions:</b> Patients who ever received a sarcoma-based regimen did not have longer OS. Since sarcoma regimens tend to have more toxicity, exclusive use of carcinoma regimens for patients with gynecologic carcinosarcomas may be beneficial.