Carcinosarcoma of the ovary
M A Harris1, L M Delap2, P S Sengupta3, P M Wilkinson1, R S Welch1, R Swindell4, J H Shanks5, G Wilson6, R J Slade7, K Reynolds7 and G C Jayson8
1Department of Clinical Oncology, Christie Hospital NHS Trust, Wilmslow Road, Withington, Manchester M20 4BX, UK
2University of Manchester Medical School, Stopford Building, Oxford Road, Manchester, UK
3Department of Gynaecological Oncology, St Mary's Hospital, Oxford Road, Manchester, UK
4Medical Statistics, Christie Hospital NHS Trust, Wilmslow Road, Withington, Manchester M20 4BX, UK
5Department of Histopathology, Christie Hospital NHS Trust, Wilmslow Road, Withington, Manchester M20 4BX, UK
6Department of Histopathology, St Mary's Hospital, Oxford Road, Manchester, UK
7Department of Gynaecological Oncology Surgery, Christie Hospital, Wilmslow Road, Withington, Manchester, UK
8Department of Medical Oncology, Christie Hospital NHS Trust, Wilmslow Road, Withington, Manchester M20 4BX, UK
Correspondence to: Dr. MA Harris, E-mail: email@example.com
We report our experience in the management of patients with carcinosarcoma of the ovary, a rare but aggressive variant of ovarian cancer.
Forty patients were treated at a single centre, which is the largest reported series. The median age at diagnosis was 65 years (range 45-86) and the median Karnofsky performance (KP) status was 70.
Thirty-two patients (80%) presented with FIGO stage III or IV disease. Twenty-four had heterologous and 14 homologous carcinosarcoma on review of histopathology, but there was no significant difference in survival between these groups (P=0.28).
Twenty-seven of the 40 patients had bulk residual disease present after surgery and this was associated with a worse prognosis (P=0.045).
Chemotherapy was given to 32 patients (80%) of whom 26 (81%) received platinum-based regimens. Of these 32 patients, three (9.4%) achieved a complete response (CR), 10 (31%) a partial response (PR), five (16%) had stable disease, 10 (31%) had progressive disease and four were not assessable. Of the 19 patients who had a CR, PR or stable disease after chemotherapy or were unevaluable (stage Ic), the median survival was 29.6 months.
Currently, seven patients are still alive although one has cancer. The overall censored median survival was 8.7 months after a median follow-up of 34 months, and the 1- and 5-year survival were 40 and 7.5%, respectively.
British Journal of Cancer (2003) 88, 654-657
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