Abstract

Background: Uterine carcinosarcomas (UCS) is rare but aggressive cancer with poor prognosis.

Aim: To evaluate clinic-pathological entities, radiological and histopathological correlation and outcome in uterine carcinosarcoma.

Method: A retrospective, hospital based observational analysis of 33 cases of uterine carcinosarcoma managed at a tertiary hospital in Kerala, between 2012 to 2018.

Results: Total 33 cases were enrolled with mean age of 60.14 years and mean parity of 2.42. Among them, 88% were postmenopausal women, 63% had postmenopausal bleeding and 39.4% were overweight. Preoperative diagnosis of UCS were made in 51.5% with endometrial biopsy and IHC. Modified radical hysterectomy was done for 16 cases (48.48%) at our center, rest were unstaged and referred. MRI had sensitivity of 87.5% and specificity of 77.7% for myoinvasion of >50% of myometrial thickness. 51.5% of cases were confined to uterus and 33.3% cases were extrauterine of which distant metastasis were common in lung and pelvic nodes. Of 8 cases of recurrence, 4 had vault recurrence. None of patient had local recurrence who underwent MRH. Out of 13 cases of combined adjuvant therapy, only one patient had vault recurrence. Mean PFS was 25.9 months (2-160 months ) and mean OS was 26.6 months (4-160 months ) from the time of diagnosis.

Conclusion: UCS is common in multiparous postmenopausal women with bleeding as commonest presentation. MRI for myoinvasion and PET-CT for distant metastasis were preferred modalities. Modified radical hysterectomy is effective with less chance of vault recurrence.