Abstract

Carcinosarcoma (malignant mixed muellerian tumor) of the ovary is a rare and aggressive tumor entity. The present study retrospectively evaluated potential prognostic factors in a series of 26 consecutive patients with primary carcinosarcoma of the ovary diagnosed and treated at the Department of Obstetrics and Gynecology of the Medical University of Graz over a 25-year period. Neither the univariate nor the multivariate analysis identified a subgroup of patients with favorable progression-free survival.

With regard to overall survival, univariate analysis revealed a favorable trend for patients < 70 years versus those > 70 years of age (5-year survival of 22% versus 0, respectively; p= 0.067). In addition, in patients with a preoperative lactate dehydrogenase (LDH)-value of < 200 U/L, also a trend towards better overall survival was observed as compared to those with a LDH concentration of > 200 U/L (p= 0.052). In multivariate analysis, age of the patients < 70 years was associated with an improved overall survival as compared to those > 70 years (34% versus 0 at 5 years, respectively; p= 0.008).

None of the other factors investigated including preoperative hemoglobin, platelet counts and lactate dehydrogenase, preoperative Karnofsky status, type of surgery, ascites, type of bowel involvement, FIGO stage, residual tumor, pelvic lymph node status, existence of a homologous or heterologous carcinosarcoma type, grade of differentiation, or postoperative chemotherapy revealed prognostic information.

The majority of recurrences were located in the pelvis, liver parenchyma and peritoneum. Although carcinosarcomas are regarded to be of epithelial origin nowadays and thus are included in trials with epithelial ovarian cancer, the authors believe that this group should be analyzed separately due to its inferior prognosis and the urgent need for intensified research in this specific tumor subtype.