Bansal N et al. - In a study to compare the clinical behavior and outcome of uterine carcinosarcomas and grade 3 endometrioid carcinomas, it was found that carcinosarcomas present at more advanced stage and have worse survival than grade 3 endometrioid carcinomas. Carcinosarcomas may represent a distinct biologic entity Methods
Data on pts with grade 3 endometrioid adenocarcinomas and uterine carcinosarcomas was obtained from the SEER database
Mortality was analyzed using Cox proportional hazards models
Survival analysis was performed with the Kaplan-Meier method and log rank test
Results
The cohort included 8986 women with 5024 (56%) grade 3 endometrioid carcinomas and 3962 (44%) uterine carcinosarcomas
Women with uterine carcinosarcomas were older and more often nonwhite
These women presented with more advanced disease (stage III/IV 41% compared with 31%)
Multivariable analysis demonstrated that uterine carcinosarcoma histology, advanced age, nonwhite race, and advanced stage were independent predictors of poor survival
Cancer-specific mortality was 45% lower in women with grade 3 endometrioid carcinomas
5-year cancer-specific survival was lower for women with uterine carcinosarcoma for each disease stage
Survival for stage IC was 38% for uterine carcinosarcoma compared with 68% for grade 3 endometrioid carcinoma
For stage III, survival was 22% for uterine carcinosarcoma compared with 45% for grade 3 endometrioid carcinoma
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