Uterine Carcinosarcoma: A Plan for Treatment

Abstract

Background: Uterine carcinosarcomas are very aggressive tumors in the womb that are associated with poor prognosis. They represent only less than 5% of uterine tumors and the incidence rate is less than 2 per 100,000 women per year. Objective: We reviewed diagnosis and treatment of women with uterine carcinosarcoma. To determine if lymphadenectomy, chemotherapy and radiotherapy are associated with decreased recurrence and increased survival. To prove that multimodality therapy including surgery, chemotherapy and radiotherapy are the ideal treatment for this malignancy. Patients and Methods: The rarity of the tumor made us depend on thirty cases done over 5 years mainly stage 1, 2 and 3 in University of Aswan between 2014 and 2018. We abstracted: histopathology results, survival outcomes from archived medical reports for the qualifying cases and patient demographics. Patient age at surgery and preoperative CA-125 for patient demographics. Histopathological results: cancer stage, depth of myometrial invasion, grade. Treatment data: Surgical details and use of postoperative adjuvant chemotherapy or radiotherapy or both. Results: Most uterine carcinosarcoma (UCS) patients are candidates for adjuvant chemotherapy combination therapy, but in-depth testing has not been widely used. The high rate of recurrence and poor overall survival indicate an ongoing need for clinical trials specifically. Hazard of death and recurrence decreased with chemotherapy multiagent and vaginal brachytherapy with five years of higher survival and disease free survival. Also lymphadenectomy decreased recurrence and rate of death associated with. Conclusion: Adjuvant chemotherapy with vaginal brachytherapy with lymphadenectomy were associated with increased survival and decreased recurrence of women with UCS.