Malignant Mixed Müllerian Tumour of the Uterus: Analysis of 44 Cases

Oncology. 2017;92(4):197-204. doi: 10.1159/000452277. Epub 2017 Jan 17.

Abstract

Objectives: The aim of our study was to evaluate the clinicopathological features and prognostic factors of uterine carcinosarcoma.

Patients and methods: In this retrospective study, the clinical characteristics of 44 patients with uterine MMMT were evaluated. Survival curves were estimated by the Kaplan-Meier method and compared by the log-rank test.

Results: Forty-four patients with uterine carcinosarcoma were referred to our unit between 1995 and 2015. Their median age was 66.5 years. All women underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. Twenty-five percent had omental resection. Pelvic lymphadenectomy was performed in 18.2% of the cases. Twenty-six of the patients presented with stage I/II disease, 17 with advanced stages. In 20.5% of the cases there were metastases at diagnosis. Forty women received adjuvant chemotherapy, with complete remission in 67.9% of the cases. Recurrences were observed in 27.3% of the women. Disease-free and overall survival was 27 and 103 months, respectively. The FIGO stage, histological type, tumour size, chemotherapy regimen, pelvic lymphadenectomy, and myometrial invasion did not affect survival.

Conclusions: Uterine MMMT is an aggressive tumour, often diagnosed at an advanced stage and with a high rate of metastases or recurrences. Because of its rarity, its management is controversial and fixed prognostic factors cannot be defined.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Carcinosarcoma / mortality
  • Carcinosarcoma / pathology
  • Carcinosarcoma / therapy
  • Chemotherapy, Adjuvant
  • Disease-Free Survival
  • Female
  • Humans
  • Hysterectomy / methods
  • Kaplan-Meier Estimate
  • Lymph Node Excision
  • Middle Aged
  • Mixed Tumor, Mullerian / mortality*
  • Mixed Tumor, Mullerian / pathology
  • Mixed Tumor, Mullerian / therapy*
  • Neoplasm Recurrence, Local / pathology
  • Ovariectomy / methods
  • Retrospective Studies
  • Uterine Neoplasms / mortality*
  • Uterine Neoplasms / pathology
  • Uterine Neoplasms / therapy*