Correlation of the Volume of Carcinomatous Component with the Clinical Stage and Nodal Metastasis in Uterine Carcinosarcoma.
Yasin Ahmed, Haitham Nasser, Mawan Al-Hajeili, Tomi Kuntzman, Bassam Albashiti, Rouba Ali-Fehmi, Paul Mazzara, Lamia Fathallah. St John Providence Hospital and Medical Center, Detroit, MI; William Beaumont Hospital, Royal Oak, MI; Wayne State University, Detroit, MI
Background: Carcinosarcoma (CS), also known as malignant mixed Müllerian tumor is an uncommon biphasic neoplasm composed of malignant epithelial and stromal components that can arise in any genital organ but most frequently in the uterus. Prognostic factors that influence the clinical outcome of the patient remain a matter of controversy. However, the most important prognostic factor is the clinical stage at the time of initial treatment. The objective of this study is to evaluate the impact of the volume of the carcinomatous (CA) component represented as percentage of tumor mass on patient's survival represented by the clinical stage as well as its correlation with nodal metastasis.
Design: 49 cases of uterine CS were obtained and evaluated in a collaborative effort of multiple institutions from the year 2001 to 2009. Microscopic slides from all tumor sections of each case were reviewed by at least two pathologists. The volume of CA component was estimated as a percentage on each tumor slide and then calculating the mean of all tumor slides of each case, with good correlation among the different examiners. All cases were staged according to the International Federation of Gynecologists & Obstetricians (FIGO) staging system.
Results: We assessed 49 cases of uterine CS. Over 30% of the cases were Stage I, 10.9% Stage II, 43.5% Stage III, and 15.2% Stage 4. Thirty one cases had lymph node information, 58.1% (18) were positive. The mean percent CA component was 55.4±28.8 (s.d.). The association between stage or lymph node status and percentage CA component was assessed using point biserial correlations, analysis of variance and Student's t-test. There was no association between stage and percent CA component (r=-0.25, p=0.09). Mean percent carcinoma by stage was 64.8±23.0, 48.8±38.7, 50.8±28.7, and 43.3±31.8 for Stages 1-4, respectively (F=1.1, p=0.4). There was also no association between lymph node status and percent CA component (r=-0.32, p=0.08). Mean percent CA by lymph node status was 63.5±19.3 and 45.7±31.0 for cases with negative and positive lymph nodes, respectively (t=1.82, p=0.08).
Conclusions: This study demonstrates no impact of either CA or sarcomatous components volumes on patient's survival or tumor stage, and also demonstrates no increase in nodal metastasis in cases with higher carcinoma volume.
Category: Gynecologic & Obstetrics
Wednesday, March 2, 2011 1:00 PM
Poster Session VI # 176, Wednesday Afternoon