Analysis of 21 cases of carcinosarcoma

Introduction: Carcinosarcomas (or Malignant Mixed Mesodermal or Müllerian Tumour) are mixed epithelial and stromal tumours with both components being malignant. Sarcomas of the female genital organs are rare. Due to the low number of cases, it is very difficult to obtain satisfying information about this disease and little is known about its pathogenesis, risk factors, optimal therapy or outcome. Methods: We analysed retrospectively the charts of 21 of our patients with homologue or heterologue carcinosarcomas who were treated between 1972 and 1996. The hospital records including pathology and operative reports of all patients were reviewed and any information on treatment, recurrence and survival was obtained. Results: The 9 patients with homologue carcinosarcoma had a median age of 60.7 years, 66.7% were postmenopausal. 55.5% had postmenopausal bleedings as main symptom. 6 patients were in FIGO stage I and II, 3 were in FIGO stage III or IV. The 12 patients with heterologue carcinosarcoma had a median age of 68.4 years, 92% were postmenopausal. In 58,3% the main symptom was a postmenopausal bleeding as well. 7 patietns were in FIGO stage I and II, 5 in FIGO stage III and IV. The majority of the patients underwent surgery and had adjuvant radiation or chemotherapy. The 1-year survival rate was 55,6% and the 5-year survival rate was 11,1% in patients with homologue carcinosarcoma and in patients with heterologue carcinosarcoma 58.3% and 8.3% respectively. These data are in accordance to the current literature. Conclusion: Carcinosarcomas of the female genital organs are a rare disease with a relatively poor prognosis. Optimal therapy regimen have not been etablished yet.