Abstract
Objective
The purpose of this retrospective study was to compare the prognoses of women with ovarian carcinosarcoma (OCS) who had optimal cytoreductive surgery followed by platinum plus taxane combination chemotherapy to those of women with ovarian high-grade serous carcinoma (HGSC) treated in the same manner.
Methods
A multicenter, retrospective department database review was performed to identify patients with OCS at eight gynecologic oncology centers in Turkey. A total of 54 women with OCS who had undergone optimal cytoreductive surgery followed by platinum plus taxane combination chemotherapy between 1999 and 2017 were included in this case–control study. Each case was matched to two women with ovarian HGSC who had undergone optimal cytoreductive surgery followed by platinum plus taxane combination chemotherapy. The Kaplan–Meier method was used to generate survival data. Factors predictive of outcome were analysed using Cox proportional hazards models.
Results
Median disease-free survival (DFS) was 29 months [95% confidence interval (CI) 0–59, standard error (SE) 15.35] versus 27 months (95% CI 22.6–31.3, SE 2.22; p = 0.765) and median overall survival (OS) was 62 versus 82 months (p = 0.53) for cases and controls, respectively. For the entire cohort, the presence of ascites [hazard ratio (HR) 2.32; 95% CI 1.02–5.25, p = 0.04] and platinum resistance [HR 5.05; 95% CI 2.32–11, p < 0.001] were found to be independent risk factors for decreased OS.
Conclusion
DFS and OS rates of patients with OCS and HGSC seem to be similar whenever optimal cytoreduction is achieved and followed by platinum plus taxane combination chemotherapy.
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References
Seidman JD, Kurman RJ (2003) Pathology of ovarian carcinoma. Hematol Oncol Clin N Am 17(4):909–925
Kounelis S, Jones MW, Papadaki H et al (1998) Carcinosarcomas (malignant mixed mullerian tumors) of the female genital tract: comparative molecular analysis of epithelial and mesenchymal components. Hum Pathol 29(1):82–87
Krishnamurti U, Sasatomi E, Swalsky PA et al (2005) Microdissection-based mutational genotyping of serous borderline tumors of the ovary. Int J Gynecol Pathol 24(1):56–61
Shylasree TS, Bryant A, Athavale R (2013) Chemotherapy and/or radiotherapy in combination with surgery for ovarian carcinosarcoma. Cochrane Database Syst Rev 28(2):CD006246
Kobel M, Kalloger SE, Huntsman DG, Brown Ovarian Cancer Outcomes Unit of the British Columbia Cancer Agency VBC et al (2010) Differences in tumor type in low-stage versus high-stage ovarian carcinomas. Int J Gynecol Pathol 29(3):203–211
Barakat RR, Berchuck A, Markman M et al (2013) Principles and practice of gynecologic oncology. 6th edn. Lippincott Williams & Wilkins, Philadelphia
Barnholtz-Sloan JS, Morris R, Malone JM et al (2004) Survival of women diagnosed with malignant, mixed mullerian tumors of the ovary (OMMMT). Gynecol Oncol 93(2):506–512
Rauh-Hain JA, Growdon WB, Rodriguez N et al (2011) Carcinosarcoma of the ovary: a case–control study. Gynecol Oncol 121(3):477–481
George EM, Herzog TJ, Neugut AI et al (2013) Carcinosarcoma of the ovary: natural history, patterns of treatment, and outcome. Gynecol Oncol 131(1):42–45
Rauh-Hain JA, Diver EJ, Clemmer JT et al (2013) Carcinosarcoma of the ovary compared to papillary serous ovarian carcinoma: a SEER analysis. Gynecol Oncol 131(1):46–51
Odicino F, Pecorelli S, Zigliani L et al (2008) History of the FIGO cancer staging system. Int J Gynaecol Obstet 101(2):205–210
Paulsson G, Andersson S, Sorbe B (2013) A population-based series of ovarian carcinosarcomas with long-term follow-up. Anticancer Res 33(3):1003–1008
Signorelli M, Chiappa V, Minig L et al (2009) Platinum, anthracycline, and alkylating agent-based chemotherapy for ovarian carcinosarcoma. Int J Gynecol Cancer 19(6):1142–1146
Rauh-Hain JA, Gonzalez R, Bregar AJ et al (2016) Patterns of care, predictors and outcomes of chemotherapy for ovarian carcinosarcoma: a National Cancer Database analysis. Gynecol Oncol 142(1):38–43
Bristow RE, Tomacruz RS, Armstrong DK et al (2002) Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era: a meta-analysis. J Clin Oncol 20(5):1248–1259
du Bois A, Reuss A, Pujade-Lauraine E et al (2009) Role of surgical outcome as prognostic factor in advanced epithelial ovarian cancer: a combined exploratory analysis of 3 prospectively randomized phase 3 multicenter trials: by the Arbeitsgemeinschaft Gynaekologische Onkologie Studiengruppe Ovarialkarzinom (AGO-OVAR) and the Groupe d’Investigateurs Nationaux Pour les Etudes des Cancers de l’Ovaire (GINECO). Cancer 115(6):1234–1244
Winter WE 3rd, Maxwell GL, Tian C et al (2008) Tumor residual after surgical cytoreduction in prediction of clinical outcome in stage IV epithelial ovarian cancer: a Gynecologic Oncology Group Study. J Clin Oncol 26(1):83–89
Leiser AL, Chi DS, Ishill NM et al (2007) Carcinosarcoma of the ovary treated with platinum and taxane: the memorial Sloan-Kettering Cancer Center experience. Gynecol Oncol 105(3):657–661
Ariyoshi K, Kawauchi S, Kaku T et al (2000) Prognostic factors in ovarian carcinosarcoma: a clinicopathological and immunohistochemical analysis of 23 cases. Histopathology 37(5):427–436
Rauh-Hain JA, Birrer M, Del Carmen MG (2016) Carcinosarcoma of the ovary, fallopian tube, and peritoneum: prognostic factors and treatment modalities. Gynecol Oncol 142(2):248–254
Chun KC, Kim JJ, Kim DY et al (2011) Optimal debulking surgery followed by paclitaxel/platinum chemotherapy is very effective in treating ovarian carcinosarcomas: a single center experience. Gynecol Obstet Invest 72(3):208–214
Jernigan AM, Fader AN, Nutter B et al (2013) Ovarian carcinosarcoma: effects of cytoreductive status and platinum-based chemotherapy on survival. Obstet Gynecol Int 2013:490–508
Doo DW, Erickson BK, Arend RC et al (2014) Radical surgical cytoreduction in the treatment of ovarian carcinosarcoma. Gynecol Oncol 133(2):234–237
Reed N, Millan D, Verheijen R et al (2010) Non-epithelial ovarian cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 21(Suppl 5):31–36
Duska LR, Garrett A, Eltabbakh GH et al (2002) Paclitaxel and platinum chemotherapy for malignant mixed mullerian tumors of the ovary. Gynecol Oncol 85(3):459–463
Brown E, Stewart M, Rye T et al (2004) Carcinosarcoma of the ovary: 19 years of prospective data from a single center. Cancer 100(10):2148–2153
Cicin I, Saip P, Eralp Y et al (2008) Ovarian carcinosarcomas: clinicopathological prognostic factors and evaluation of chemotherapy regimens containing platinum. Gynecol Oncol 108(1):136–140
Tate Thigpen J, Blessing JA, DeGeest K et al (2004) Cisplatin as initial chemotherapy in ovarian carcinosarcomas: a Gynecologic Oncology Group study. Gynecol Oncol 93(2):336–339
Gynecologic Oncology Group (2014) A randomized phase III trial of paclitaxel plus carboplatin versus ifosfamide plus paclitaxel in chemotherapy-naive patients with newly diagnosed stage I–IV persistent or recurrent carcinosarcoma (mixed mesodermal tumor) of the uterus or ovary. http://clinicaltrials.gov/show/NCT00954174. Accessed 17 June 2017
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Yalcin, I., Meydanli, M.M., Turan, A.T. et al. Carcinosarcoma of the ovary compared to ovarian high-grade serous carcinoma: impact of optimal cytoreduction and standard adjuvant treatment. Int J Clin Oncol 23, 329–337 (2018). https://doi.org/10.1007/s10147-017-1215-x
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DOI: https://doi.org/10.1007/s10147-017-1215-x