Abstract
Background: Carcinosarcoma is a rare malignancy, and reports are often mixed along with other
sarcomas. The literature on uterine carcinosarcoma per se is sparse. Aims: This study aims to evaluate the demography, survival, and optimal treatment strategy
of uterine carcinosarcoma. Settings and Design: A tertiary care center in India. The study design was descriptive with survival analysis.
Materials and Methods: The medical records of all 18 patients admitted with uterine carcinosarcoma between
January 2011 and December 2015 were reviewed. Baseline characteristics and outcomes
were studied. Survival analysis was done using the Kaplan–Meier method and compared
between treatment groups using the Log-rank test. Results: The total number of uterine malignancies operated in our center over this time period
was 311 of which 18 were carcinosarcomas (5.7%). Median age of presentation was 61
years (36–77 years). Most women (94%) were postmenopausal and 67% of them presented
with postmenopausal bleeding. Over half of the patients (56%) presented late (Stage
III or IV). Only 11 (61%) had adjuvant treatment and 7 patients had expired at the
time of follow-up. The median survival was 284 days (95% confidence interval 107–461).
Patients who received adjuvant therapy did better compared to those who did not (P = 0.036). Conclusions: Carcinosarcomas are aggressive tumors of postmenopausal women who present with bleeding
or discharge per vaginum. In spite of adequate surgical staging followed by adjuvant
therapy, survival remains poor. Improvements in early detection and optimal therapy
need to be made.
Key words
Carcinosarcoma - survival - treatment
