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Observational Study
. 2023 Aug;149(9):6479-6488.
doi: 10.1007/s00432-023-04594-5. Epub 2023 Feb 11.

Is the sarcomatous component (homologous vs heterologous) the prognostic "driving force" in early-stage uterine carcinosarcomas? A retrospective multicenter study

A Rosati  1 , V Vargiu  2 , C Certelli  1 , M Arcieri  1 , E Vizza  3 , F Legge  4 , F Cosentino  2   5 , G Ferrandina  1   6 , F Fanfani  1   6 , G Scambia  1   6 , G Corrado  7
Affiliations
Observational Study

Is the sarcomatous component (homologous vs heterologous) the prognostic "driving force" in early-stage uterine carcinosarcomas? A retrospective multicenter study

A Rosati et al. J Cancer Res Clin Oncol. 2023 Aug.

Abstract

Purpose: Uterine carcinosarcomas (UCSs) are aggressive biphasic malignancies, with a carcinomatous/epithelial component and a sarcomatous/mesenchymal counterpart. The aim of this study was to evaluate the impact of the sarcomatous component (homologous vs heterologous) on the overall survival (OS) and progression-free survival (PFS).

Methods: This is a multicenter observational retrospective study conducted in patients with stage I and II UCSs.

Results: Ninety-five women with histological diagnosis of early-stage UCSs were retrieved: 60 (63.2%) had tumors with homologous sarcomatous components, and 35 (36.8%) with heterologous. At univariate analysis, a stromal invasion ≥ 50%, the presence of clear cell, serous or undifferentiated carcinomatous component, the heterologous sarcomatous component and FIGO stage IB and II were shown to be variables with a statistically significant negative impact on PFS. Similarly, a depth of invasion ≥ 50%, the heterologous sarcomatous component and FIGO stage IB and II were statistically negative prognostic factors also concerning OS. At multivariate analysis, only the heterologous sarcomatous component was confirmed to be a statistically significant negative prognostic factor both on PFS (HR 2.362, 95% CI 1.207-4.623, p value = 0.012) and on OS (HR 1.950, 95% CI 1.032-3.684, p = 0.040).

Conclusion: Carcinomatous and sarcomatous components both played a role in tumor progression and patients' survival. However, only the sarcomatous component retained a statistical significance at the multivariable model suggesting its preeminent prognostic role in early-stage UCSs.

Keywords: Heterologous component; Homologous component; Malignant mixed mullerian tumors; Sarcomatous component; Uterine carcinosarcomas.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
Kaplan–Meier plots for progression-free survival and overall survival
Fig. 2
Fig. 2
Kaplan–Meier plots for progression-free survival and overall survival according to the histological sarcomatous subtype component (A progression-free survival, B overall survival)
See this image and copyright information in PMC

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