Journal of Cancer Research and Clinical Oncology

, Volume 130, Issue 11, pp 645–648

Chemotherapeutic management of recurrent/metastatic uterine carcinosarcomas (malignant mixed mullerian tumors): time for a re-appraisal?

Original Paper



Optimal chemotherapeutic management of recurrent/metastatic uterine carcinosarcomas remains undefined. Despite this fact, the selection of a cytotoxic anti-neoplastic drug regimen for an individual patient with this rare malignancy may substantially impact both short-term symptomatic improvement and overall quality-of-life, which includes the toxicity of therapy.

Patients and methods

Two women with metastatic uterine carcinosarcomas recently treated at the Cleveland Clinic received therapy (carboplatin/paclitaxel) directly aimed at the “adenocarcinoma” component of their mixed endometrial cancers.


Both patients achieved substantial short-term objective and subjective improvement in cancer-related signs and symptoms, while experiencing limited treatment-associated toxicities.


This limited experience, and additional available data, suggest it is rational to initially treat patients with recurrent/metastatic uterine carcinosarcomas with anti-neoplastic drug strategies currently employed in the management of endometrial adenocarcinomas.


Uterine carcinosarcoma Carboplatin Paclitaxel 


  1. Berchuck A, Rubin SC, Hoskins WJ, Saigo PE, Pierce VK, Lewis JL Jr (1988) Treatment of uterine leiomyosarcoma. Obstet Gynecol 71:845–850PubMedGoogle Scholar
  2. Bitterman P, Chun B, Kurman RJ (1990) The significance of epithelial differentiation in mixed mesodermal tumors of the uterus: a clinicopathologic and immunohistochemical study. Am J Surg Pathol 14:317–328PubMedGoogle Scholar
  3. Burke TW, Stringer CA, Morris M, Freedman RS, Gershenson DM, Kavanagh JJ, Edwards CL (1991) Prospective treatment of advanced or recurrent endometrial carcinoma with cisplatin, doxorubicin, and cyclophosphamide. Gynecol Oncol 40:264-267CrossRefPubMedGoogle Scholar
  4. Dimopoulos MA, Papadimitriou CA, Georgoulias V, Moulopoulos LA, Aravantinos G, Gika D, Karpathios S, Stamatelopoulos S (2000) Paclitaxel and cisplatin in advanced or recurrent carcinoma of the endometrium: long-term results of a phase II multicenter study. Gynecol Oncol 78:52–57CrossRefPubMedGoogle Scholar
  5. Dunton CJ, Pfeifer SM, Braitman LE, Morgan MA, Carlson JA, Mikuta JJ (1991) Treatment of advanced and recurrent endometrial cancer with cisplatin, doxorubicin, and cyclophosphamide. Gynecol Oncol 41:113–116CrossRefPubMedGoogle Scholar
  6. Edmonson JH, Blessing JA, Cosin JA, Miller DS, Cohn DE, Rotmensch J (2002) Phase II study of mitomycin, doxorubicin, and cisplatin in the treatment of advanced uterine leiomyosarcoma: a Gynecologic Oncology Group study. Gynecol Oncol 85:507–510CrossRefPubMedGoogle Scholar
  7. Fleming GF, Fowler JM, Waggoner SE, Copeland LJ, Greer BE, Horowitz I, Sutton G, Schilder RJ, Fracasso PM, Ball HG, McGuire III WP (2001) Phase I trial of escalating doses of paclitaxel combined with fixed doses of cisplatin and doxorubicin in advanced endometrial cancer and other gynecologic malignancies: a Gynecologic Oncology Group study. J Clin Oncol 19:1021–1029PubMedGoogle Scholar
  8. Fleming GF, Brunetto VL, Mundt AJ, Burks RT, Look KY, Reid G (2002) Randomized trial of doxorubicin (DOX) plus cisplatin (CIS) versus DOX plus CIS plus paclitaxel (TAX) in patients with advanced or recurrent endometrial carcinoma: a Gynecologic Oncology Group (GOG) study. Proc Am Soc Clin Oncol 21:202aGoogle Scholar
  9. Gallion HH, Brunetto VL, Cibull M, Lentz SS, Reid G, Soper JT, Burger RA, Andersen W (2003) Randomized phase III trial of standard timed doxorubicin plus cisplatin versus circadian timed doxorubicin plus cisplatin in stage III and IV or recurrent endometrial carcinoma: a Gynecologic Oncology Group study. J Clin Oncol 21:3808–3813CrossRefPubMedGoogle Scholar
  10. Hawkins RE, Wiltshaw E, Mansi JL (1990) Ifosfamide with and without adriamycin in advanced uterine leiomyosarcoma. Cancer Chemother Pharmacol 26:S26–29PubMedGoogle Scholar
  11. Hoskins PJ, Swenerton KD, Pike JA, Wong F, Lim P, Acquino-Parsons C, Lee N (2001) Paclitaxel and carboplatin, alone or with irradiation, in advanced or recurrent endometrial cancer: a phase II study. J Clin Oncol 9:4048–4053Google Scholar
  12. Le T, Krepart GV, Lotocki RJ, Heywood MS (1997) Malignant mixed mesodermal ovarian tumor treatment and prognosis: a 20-year experience. Gynecol Oncol 65:237–240CrossRefPubMedGoogle Scholar
  13. Levenback CF, Tortolero-Luna G, Pandey DK, Malpica A, Baker VV, Whittaker L, Johnson E, Mitchell MF (1996) Uterine sarcoma. Obstet Gynecol Clin North Am 23:457–473PubMedGoogle Scholar
  14. Moore TD, Phillips PH, Nerenstone SR, Cheson BD (1991) Systemic treatment of advanced and recurrent endometrial carcinoma: current status and future directions. J Clin Oncol 9:1071–1088PubMedGoogle Scholar
  15. Pearl ML, Inagami M, McCauley DL, Valea FA, Chalas E, Fischer M (2002) Mesna, doxorubicin, ifosfamide, and dacarbazine (MAID) chemotherapy for gynecological sarcomas. Int J Gynecol Cancer 12:745–748CrossRefPubMedGoogle Scholar
  16. Price FV, Edwards RP, Kelley JL, Kunschner AJ, Hart LA (1997) A trial of outpatient paclitaxel and carboplatin for advanced, recurrent, and histologic high-risk endometrial carcinoma: preliminary report. Semin Oncol 24 [Suppl 15]:S15–78-S15–82Google Scholar
  17. Ramondetta LM, Burke TW, Jhingran A, Schmandt R, Bevers MW, Wolf JK, Levenback CF, Broaddus RA (2003) phase II trial of cisplatin, ifosfamide, and mesna in patients with advanced or recurrent uterine malignant mixed mullerian tumors with evaluation of potential molecular targets. Gynecol Oncol 90:529–536CrossRefPubMedGoogle Scholar
  18. Silverberg SG, Major FJ, Blessing JA, Fetter B, Askin FB, Liao S-Y, Miller A (1990) Carcinosarcoma (malignant mixed mesodermal tumor) of the uterus A Gynecologic Oncology Group pathologic study of 203 cases. Int J Gynecol Pathol 9:1–19PubMedGoogle Scholar
  19. Sutton G, Brunetto VL, Kilgore L, Soper JT, McGehee R, Olt G, Lentz SS, Sorosky J, Hsiu J-G (2000) A phase III trial of ifosfamide with or without cisplatin in carcinosarcoma of the uterus: a Gynecologic Oncology Group study. Gynecol Oncol 79:147–153CrossRefPubMedGoogle Scholar
  20. Sutton GP, Blessing JA, Barrett RJ, McGehee R (1992) Phase II trial of ifosfamide and mesna in leiomyosarcoma of the uterus: a Gynecologic Oncology Group study. Am J Obstet Gynecol 166:556–559PubMedGoogle Scholar
  21. Thigpen JT, Blessing JA, Beecham J, Homesley H, Yordan E (1991) Phase II trial of cisplatin as first-line chemotherapy in patients with advanced or recurrent uterine sarcomas: a Gynecologic Oncology Group study. J Clin Oncol 9:1962–1966PubMedGoogle Scholar
  22. Thigpen T, Blessing J, Homesley H, Malfetano J, DiSaia P, Yordan E (1993) Phase III trial of doxorubicin +/- cisplatin in advanced or recurrent endometrial carcinoma: a Gynecologic Oncology Group (GOG) study. Proc Am Soc Clin Oncol 12:261Google Scholar
  23. Zanotti KM, Belinson JL, Kennedy AW, Webster KD, Markman M (1999) The use of paclitaxel and platinum-based chemotherapy in uterine papillary serous carcinoma. Gynecol Oncol 74:272–277CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  1. 1.University of Texas M.D. Anderson Cancer Center1515 Holcombe BoulevardHoustonUSA
  2. 2.The Cleveland Clinic FoundationClevelandUSA

Personalised recommendations