Uterine Carcinosarcoma: Outcome of Management of Eight Cases

Carcinosarcoma also previously called malignant mixed mullerian tumor are relatively rare cancers composed of an admixture of epithelial and mesenchymal elements. They account for less than 5% of all uterine cancers and only a few cases have been reported in our population. This study aimed to determine the proportion of carcinosarcoma among the patients managed for uterine cancer in our hospital, the clinical presentations, histological variants, and their treatment outcomes.

A retrospective review of the clinical experience at our Gynecological Oncology unit in the management of carcinosarcoma over a period of 2017–2022. Medical records were abstracted for demographic data, clinical presentations, surgical stage, number of courses of adjuvant chemotherapy, follow-up, and treatment outcomes and analyzed.

In the period under review, a total of 32 patients with uterine cancer were seen. Twenty-three had endometrial cancer (71.9%), 8 had carcinosarcoma (25.0%) and one had uterine sarcoma (3.1%). Most women with carcinosarcoma were postmenopausal, aged 52–85 years with a mean age of 66.4 years. Four had homologous and the other 4 had heterologous histologic subtypes. All four with the heterologous histology died within three months of surgery while three with the homologous histology are still alive with survival ranging from 1 to 6 years. Carcinosarcoma, though rare was relatively common in this review, constituting 25% of uterine cancers seen over the period under review. All patients with the heterologous subtype presented with more advanced disease and died within three months of surgery.