Uterine carcinosarcoma: A multicentre review of treatment and outcomes over 26 years.

Abstract

Objectives Uterine carcinosarcoma (UCS) is a rare neoplasm with a poor prognosis and a paucity of evidence on treatment. The objective was to review the characteristics, treatment and outcomes of UCS cases across two gynaeoncology units and five private gynaeoncology practices in Melbourne. Methods UCS cases were identified from hysterectomy pathology records between 1994 and 2020 inclusive. Patient characteristics, histopathological stage, adjuvant therapy, recurrence and survival status were extracted from patient records. Results 208 cases of UCS were identified. The overall recurrence rate was 26.0% and the overall death rate was 60.1%. Increasing age at diagnosis was associated with an increased risk of death (adjusted OR 1.04, 95% CI 1.01-1.08, p=0.019). Risk of death was highest in Stage III disease (adjusted OR 4.37, 95% CI 1.67-11.40). Recurrence was a strong determinant of death, with an adjusted OR of 7.58 (p<0.001). Conclusions In this relatively large homogenous cohort of UCS cases, significant predictors for survival included age at diagnosis, stage of disease and recurrence.