Radiotherapy helps prevent distant metastasis in uterine carcinosarcoma

Adjuvant pelvic radiotherapy shows promise in reducing the rate of distant metastases among patients with uterine carcinosarcoma (UCS), reports a study. However, it appears to offer no statistically significant improvements in survival metrics.

A retrospective review was performed on all patients who underwent surgical resection for UCS between 1993 and 2011 at a single institution to assess survival rates between surgical resection alone and combinations of surgery, chemotherapy, and radiotherapy.

The authors evaluated 3-year disease-free survival, locoregional recurrence-free survival, distant metastases-free survival (DMFS), and overall survival rates. They also analysed differences between UCS treatment modalities using Kaplan-Meier modeling.

Between 1993 and 2011, 24 patients (mean age 61 years, range 39–75 years) underwent UCS surgical resection. Of these, 24 (100 percent) submitted to surgical resection, six (25 percent) had surgery and adjuvant chemotherapy, seven (29 percent) went through surgery and adjuvant radiotherapy, and eight (33 percent) undertook surgery and adjuvant chemotherapy and radiotherapy.

No significant difference was observed in overall survival between treatment modalities at a median follow-up of 3 years. The addition of radiotherapy resulted in increased DMFS in patients undergoing surgery regardless of adjuvant chemotherapy (44 percent vs 83 percent; p=0.0211).

In patients receiving adjuvant chemotherapy, the significant increase in DMFS continued with the addition of radiotherapy (p=0.0310). Additionally, lymph node involvement (n=8) correlated with a lower locoregional recurrence-free survival (38 percent vs 92 percent; p=0.0029).

“UCS are rare tumours that carry a poor prognosis and high recurrence rate,” the authors said. “Standard treatment consists of surgical resection and chemotherapy.