A clinicopathologic study of 30 patients with mixed mesodermal tumor of the endometrium is presented. An over-all 5-year survival rate of 21% was obtained which compares favorably with figures in the literature. Prompt hysterectomy and bilateral salpingo-oopherectomy is the treatment of choice. Preoperative irradiation destroys the local tumor in a minority of cases, does not improve the survival rate and delays definitive surgery for a tumor known to grow and spread rapidly. Histologic subclassification does not correlate well with survival but superficial growth and lack of penetration of the myometrium are significant prognostic factors.
URING A RECENT STUDY OF ENDOMETRIAL
D adenocarcinomas seen at Harper Hos-pita1 between 1948 and 1957,l we encountered 17 malignant mixed mesodermal tumors of the uterus and have seen another 13 cases through 1964. T h e literature on mixed mesodermal tumors consists mostly of single case reports and occasional small series reported from a single institution. T h e largest prior series, that of Sternberg et a1.8 in 1954, contained 21 cases but included tumors of the cervix and vagina.
Mixed mesodermal tumors are highly malignant neoplasms originating from specialized mesodermal tissue derived from the miillerian duct. They appear as vaginal tumors in children, cervical lesions during childbearing life and as fundal tumors in postmenopausal women. Terminology for these tumors has included "carcinosarcoma" and "sarcoma botryoides" among others but it is doubtful if such subclassification has any practical value. Most reports indicate that the prognosis is bad and only sporadic reports of 5-year cures appear in the literature. Therapy has been controversial especially regarding the efficacy of combined radiotherapy and surgery over radical surgery alone.
Because of the lack of a large reported series observed in a single institution, we decided to study our cases in an attempt to delineate factors important in diagnosis, treatment and prognosis of this neoplasm. T h e results of such a study are reported herein.