Carcinosarcoma of Uterus and Ovary: A Comparative Histological and Clinical Analysis
M Jamali, M Rouzbahman, F Siadat, B Clarke, G Rasty. University of Toronto, Toronto, ON, Canada; University of Ottawa, Ottawa, ON, Canada
Background: Carcinosarcoma of uterine corpus and ovary are high-grade malignancies of female genital tract. While both malignancies have similar morphological features, there are differences in the biology of these tumors, type and percentage of different components, modes of spread and patient's outcome. The object of this study is to compare these two groups of tumors in terms of different components, clinical stage and correlation of these pathological parameters with patients' outcome.
Design: The pathology database at University Health Network was searched and 42 cases of uterine carcinosarcoma (UC) and 6 cases of ovarian carcinosarcoma (OC) available were retrieved in the period of 2001-2008. Two Gynecologic pathologists reviewed the H& E slides of the cases. Types and percentage of different components as well as pathologic and clinical stage, status of lymph nodes, status of peritoneal washing and patient's outcome were documented.
Results: The median age for both groups of patient (UC) and (OC) was 69.5. All except one patient underwent surgery (TAH-BSO) and pelvic lymphadenectomies were done in 20 patients. The epithelial component in patients with (UC) made 53.3% of the tumor, which was serous type in 16 cases, endometrioid in 11, and mixed cell types in 15 patients and the mesenchymal element was mainly homologous (stromal sarcoma or leiomyosarcoma) in (28, 66.7%). In (OC), the epithelial component was 70% of the tumor with 3 of them being serous, one endometrioid and 2 mixed cell types and the mesenchymal element was homologous in 50% of cases. In patients with (UC), 20 were FIGO stage I, 3 stage II, 15 stage III and 4 patients stage IV. In patients with (OC), one was FIGO stage I, one stage II, 3 stage III and one stage IV. At the time of analysis, 9 patients were lost to follow-up (uterine group), six patients died of disease (26.2%), 10 alive without disease, 7 alive with disease and 7 in treatment. In (OC) 2 patients were dead of disease (33.3%), 1 is alive with disease and 3 are in treatment.
Conclusions: Serous carcinoma appeared to be the most common epithelial component in this series for both ovarian and uterine carcinosarcomas. The sarcomatous component is mainly homologous in (UC), with heterologous component being more frequent in (OC). It seems that OC shows less favorable outcome in comparison to uterine counterpart in higher stage of the disease. However a larger group of patients may be needed for a more accurate evaluation.
Wednesday, March 11, 2009 1:00 PM
Poster Session VI # 162, Wednesday Afternoon