Role of Radiation Therapy in the Multidisciplinary Management of Uterine Carcinosarcoma

Gunther, Jillian R.; Christensen, Eva; Allen, Pamela K.; Ramondetta, Lois M.; Jhingran, Anuja; Fleming, Nicole D.; Euscher, Elizabeth D.; Lu, Karen H.; Eifel, Patricia J.; Klopp, Ann H.

doi:10.1097/igc.0000000000001135

Cited by 14 publications

(11 citation statements)

References 28 publications

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“…In our study 69 % of the patients received chemotherapy as well as a half of all patients received the radiotherapy. There are some studies showing positive effect of adjuvant radiotherapy on the prognosis for all stages of the UCS [18,19]. It is not possible to discuss the contribution of radiotherapy or chemotherapy in our cases due to low number of patients.…”

Section: Discussionmentioning

confidence: 83%

Prognostic significance of programmed death-1 (PD-1) and programmed death-ligand 1 (PD-L1) expression in uterine carcinosarcoma

Güleç

Bağır

Paydaş

et al. 2020

European Journal of Obstetrics & Gynecology and Reproductiv

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Section: Discussionmentioning

confidence: 83%

Prognostic significance of programmed death-1 (PD-1) and programmed death-ligand 1 (PD-L1) expression in uterine carcinosarcoma

Güleç

Bağır

Paydaş

et al. 2020

European Journal of Obstetrics & Gynecology and Reproductiv

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“…The principal treatment for MMMT of the uterus is surgery, but the high rates of both local and distant relapse after surgery have demonstrated the need for effective adjuvant therapies. Surgery, including hysterectomy and bilateral salpingooopherectomy with surgical staging, is the mainstay of treatment of malignant mixed Mullerian tumour (MMMT) 11 . Indication of adjuvant radiation therapy for the treatment of carcinosarcoma are post-operative residual disease or surgical inaccessible sites as well as lymph node status.…”

Section: Discussion Of Treatmentmentioning

confidence: 99%

“…13 External beam radiation therapy improves locoregional control in all stages. 14 Radiation therapy to be given in doses of 50-60 Gy to the pelvis. 12…”

Section: Discussion Of Treatmentmentioning

confidence: 99%

“…Prognostic factors of MMMT are surgical stage, lymphovascular space invasion (LVSI), depth of myometrial invasion, tumor histology, and patient age. 11 Since MMMTs are extremely rare and there is a paucity of data, we conducted the present study to analyse the outcome of this type of tumour. Here we report two cases of malignant mixed Mullerian tumor of the uterus with homologous elements.…”

Section: Introductionmentioning

confidence: 99%

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Malignant mixed Mullerian tumour (MMMT) of uterus: Rare and aggressive Tumor

Chandrasekaran¹

2019

jmscr

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“…Until better treatment options become available, the best approach is multimodal with both chemotherapy and radiotherapy (Table 2). 38–70 Notably, as for all high-risk histotypes, chemotherapy plays a central role in the management of patients with endometrial carcinosarcoma 68…”

Section: Standard Treatmentmentioning

confidence: 99%

Endometrial carcinosarcoma

Bogani

Ray‐Coquard

Concin

et al. 2022

Int J Gynecol Cancer

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Endometrial carcinosarcoma is a rare and aggressive high-grade endometrial carcinoma with secondary sarcomatous trans-differentiation (conversion theory). The clinical presentation and diagnostic work-up roughly align with those of the more common endometrioid counterpart, although endometrial carcinosarcoma is more frequently diagnosed at an advanced stage. Endometrial carcinosarcoma is not a single entity but encompasses different histological subtypes, depending on the type of carcinomatous and sarcomatous elements. The majority of endometrial carcinosarcomas are characterized by p53 abnormalities. The proportion ofPOLEand microsatellite instablity-high (MSI-H) is directly related to the epithelial component, being approximately 25% and 3% in endometrioid and non-endometrioid components.The management of non-metastatic disease is based on a multimodal approach with optimal surgery followed by (concomitant or sequential) chemotherapy and radiotherapy, even for early stages. Palliative chemotherapy is recommended in the metastatic or recurrent setting, with carboplatin/paclitaxel doublet being the first-line regimen. Although the introduction of immunotherapy plus/minus a tyrosine kinase inhibitor shifted the paradigm of treatment of patients with recurrent endometrial cancer, patients with endometrial carcinosarcoma were excluded from most studies evaluating single-agent immunotherapy or the combination. However, the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA) approved the use of pembrolizumab and lenvatinib in endometrial cancer (all histotypes) after progression on chemotherapy and single-agent immunotherapy in MSI-H cancers. In the era of precision medicine, emerging knowledge on molecular endometrial carcinosarcoma is opening new promising therapeutic options for more personalized treatment. The present review outlines state-of-the-art knowledge and future directions for patients with endometrial carcinosarcoma.

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Role of Radiation Therapy in the Multidisciplinary Management of Uterine Carcinosarcoma

Abstract: Patients with UC have a high rate of relapse in the regional nodes and distant sites. External beam radiation therapy improves locoregional control in all stages and may improve survival in stage III patients who are at the highest risk of pelvic relapse.

Cited by 14 publications

References 28 publications

Prognostic significance of programmed death-1 (PD-1) and programmed death-ligand 1 (PD-L1) expression in uterine carcinosarcoma

Prognostic significance of programmed death-1 (PD-1) and programmed death-ligand 1 (PD-L1) expression in uterine carcinosarcoma

Malignant mixed Mullerian tumour (MMMT) of uterus: Rare and aggressive Tumor

Endometrial carcinosarcoma

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