Prognostic factors in uterine carcinosarcoma : A clinicopathologic study of 25 patients

✍ Scribed by Yoko Iwasa; Hironori Haga; Ikuo Konishi; Yoichiro Kobashi; Kayoko Higuchi; Eiji Katsuyama; Sachiko Minamiguchi; Hirohiko Yamabe

• Publisher: John Wiley and Sons
• Year: 1998
• Tongue: English
• Weight: 200 KB
• Volume: 82
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/(sici)1097-0142(19980201)82:3<512::aid-cncr13>3.0.co;2-4

✦ Synopsis

Background:

Carcinosarcoma (malignant mixed mullerian tumor) of the female genital tract is a highly malignant neoplasm. the tumor stage and histologic grade of the carcinomatous component are among the important prognostic indicators cited in the literature for this tumor.

Methods:

Twenty-five patients with uterine carcinosarcoma at 4 hospitals in the kyoto and nara areas of japan were studied retrospectively. the clinicopathologic and immunohistochemical data including p53, bcl-2, ki-67, and proliferating cell nuclear antigen (pcna) staining were analyzed using univariate and multivariate analysis with the cox proportional hazards model to investigate potential prognostic indicators for this neoplasm.

Results:

The 5-year survival rate was 36.4% for all stages, 62.3% for stage i, and 0% for stages ii-iv. from the univariate analysis, stage (p = 0.0001), endometrioid adenocarcinoma as a carcinomatous component (p = 0.0006), age (p = 0.0355), and a heterologous sarcomatous component (p = 0.0421) were found to be prognostically significant for patient survival. stage was the only independent significant factor in the multivariate analysis (t = 2.212). none of the other factors (history of pregnancy and gestation, gross appearance of the tumors, grade of the carcinomatous component, mitotic count of the sarcomatous component, ki-67 and pcna reactivity, or p53 or bcl-2 positive staining) was found to be a significant prognostic indicator.

Conclusions:

Stage appears to be the only definite independent prognostic indicator of survival in patients with uterine carcinosarcoma. it is uncertain whether age, endometrioid adenocarcinoma as a carcinomatous component, or absence of a heterologous component in the sarcomatous area are prognostic factors. immunohistochemical expression of p53, bcl-2, ki-67, or pcna is not a prognostic indicator. the immunohistochemical results of the current study may support the hypothesis of a common stem cell origin of this tumor.