The aim of this study was to elucidate the clinicopathological and immunohisto chemical prognostic factors of patients with ovarian carcinosarcoma treated with radical surgery and postoperative chemotherapy. During a ...The aim of this study was to elucidate the clinicopathological and immunohisto chemical prognostic factors of patients with ovarian carcinosarcoma treated with radical surgery and postoperative chemotherapy. During a 6-year period, nine p atients with ovarian carcinosarcoma were referred to our institution. Tissue blo cks were reviewed and sections containing both carcinomatous and sarcomatous ele ments were stained for epithelial membrane antigen (EMA), vimentin, vascular end othelial growth factor (VEGF), CD45RO, c-erbB-2, p53, CD34, Ki67, S100, estrog en, and progesterone receptors. Histological and immunohistochemical findings as well as clinical characteristics were then correlated with progression-free in terval and overall survival. There were four homologous and five heterologous ca rcinosarcomas. Five patients had early stage disease. Seven of the patients were optimally debulked. All patients were treated with anthracycline-based chemoth erapy following surgery. With regard to immunohistochemistry, all specimens were negative for CD34, c-erbB-2, estrogen, and progesterone receptor expression. Five tumors overexpressed p53 and four specimens demonstrated a positive stainin g for Ki67. Reactivity for VEGF and CD45RO was observed in four and two tumor sp ecimens, respectively. The median overall survival was 32.9 months with no stati stical difference between early and advanced stages, while median time to progre ssion was 13.5 months. p53 overexpression demonstrated a trend for better overal l survival. Only p53 overexpression seems to influence overall survival although , due to the small number of patients studied, no safe conclusions can be drawn. Despite the predominance of early stage patients that favorably influenced over all survival, aggressive surgical cytoreduction followed by anthracycline-based treatment were the cornerstone in our multimodality approach.展开更多
To evaluate our experience with ovarian carcinosarcoma and identify prognostic factors. Methods. Thirty-one cases of ovarian carcinosarcoma were identified over a 6- year time period through tumor registry and patholo...To evaluate our experience with ovarian carcinosarcoma and identify prognostic factors. Methods. Thirty-one cases of ovarian carcinosarcoma were identified over a 6- year time period through tumor registry and pathology records. Fisher exact test and log rank using Kaplan-Meier method (P < 0.05) were used to compare variables with outcome. Results. All 31 patients underwent initial surgical treatment with an appropriate staging procedure. Stage distribution: 1 stage I, 6 stage II, 23 stage III, and 1 stage IV. The median followup was 28 months. The median survival for the entire group was 21 months. Early vs. advanced stage significantly influenced progression-free interval, P = 0.05. Nineteen patients were found to have stage IIIC disease and required debulking procedures. In patients with stage IIIC disease, presence of residual disease was associated with decreased overall survival, P = 0.03. 29 patients received adjuvant chemotherapy with 11 patients receiving ifosfamide/cisplatin and 16 patients receiving carboplatin/taxol. Progression-free interval was improved with the use of ifosfamide/cisplatin vs. carboplatin/taxol. The median PFI was 12 months in the carbo/taxol group and has not been reached in the ifos/cisplatin group (P = 0.005). The overall survival was also significantly improved with the use of ifosfamide/cisplatin, P = 0.03. In advanced stage patients, overall survival was not significantly influenced by type of adjuvant chemotherapy administered, P = 0.13. Conclusions. Ovarian carcinosarcoma has a poor overall prognosis with median survival rates reported in the literature ranging from 7- 10 months. Our series, although limited by a small number of patients, exhibits a more encouraging median survival of 21 months for the overall group. Aggressive debulking to eliminate residual disease and the use of ifosfamide/cisplatin chemotherapy seem to be factors in this improved outcome.展开更多
文摘The aim of this study was to elucidate the clinicopathological and immunohisto chemical prognostic factors of patients with ovarian carcinosarcoma treated with radical surgery and postoperative chemotherapy. During a 6-year period, nine p atients with ovarian carcinosarcoma were referred to our institution. Tissue blo cks were reviewed and sections containing both carcinomatous and sarcomatous ele ments were stained for epithelial membrane antigen (EMA), vimentin, vascular end othelial growth factor (VEGF), CD45RO, c-erbB-2, p53, CD34, Ki67, S100, estrog en, and progesterone receptors. Histological and immunohistochemical findings as well as clinical characteristics were then correlated with progression-free in terval and overall survival. There were four homologous and five heterologous ca rcinosarcomas. Five patients had early stage disease. Seven of the patients were optimally debulked. All patients were treated with anthracycline-based chemoth erapy following surgery. With regard to immunohistochemistry, all specimens were negative for CD34, c-erbB-2, estrogen, and progesterone receptor expression. Five tumors overexpressed p53 and four specimens demonstrated a positive stainin g for Ki67. Reactivity for VEGF and CD45RO was observed in four and two tumor sp ecimens, respectively. The median overall survival was 32.9 months with no stati stical difference between early and advanced stages, while median time to progre ssion was 13.5 months. p53 overexpression demonstrated a trend for better overal l survival. Only p53 overexpression seems to influence overall survival although , due to the small number of patients studied, no safe conclusions can be drawn. Despite the predominance of early stage patients that favorably influenced over all survival, aggressive surgical cytoreduction followed by anthracycline-based treatment were the cornerstone in our multimodality approach.
文摘To evaluate our experience with ovarian carcinosarcoma and identify prognostic factors. Methods. Thirty-one cases of ovarian carcinosarcoma were identified over a 6- year time period through tumor registry and pathology records. Fisher exact test and log rank using Kaplan-Meier method (P < 0.05) were used to compare variables with outcome. Results. All 31 patients underwent initial surgical treatment with an appropriate staging procedure. Stage distribution: 1 stage I, 6 stage II, 23 stage III, and 1 stage IV. The median followup was 28 months. The median survival for the entire group was 21 months. Early vs. advanced stage significantly influenced progression-free interval, P = 0.05. Nineteen patients were found to have stage IIIC disease and required debulking procedures. In patients with stage IIIC disease, presence of residual disease was associated with decreased overall survival, P = 0.03. 29 patients received adjuvant chemotherapy with 11 patients receiving ifosfamide/cisplatin and 16 patients receiving carboplatin/taxol. Progression-free interval was improved with the use of ifosfamide/cisplatin vs. carboplatin/taxol. The median PFI was 12 months in the carbo/taxol group and has not been reached in the ifos/cisplatin group (P = 0.005). The overall survival was also significantly improved with the use of ifosfamide/cisplatin, P = 0.03. In advanced stage patients, overall survival was not significantly influenced by type of adjuvant chemotherapy administered, P = 0.13. Conclusions. Ovarian carcinosarcoma has a poor overall prognosis with median survival rates reported in the literature ranging from 7- 10 months. Our series, although limited by a small number of patients, exhibits a more encouraging median survival of 21 months for the overall group. Aggressive debulking to eliminate residual disease and the use of ifosfamide/cisplatin chemotherapy seem to be factors in this improved outcome.
