Therapy Modalities, Prognostic Factors, and Outcome of the Primary Cervical Carcinosarcoma: Meta-analysis of Extremely Rare Tumor of Cervix

Cömert, Günsu Kimyon; Türkmen, Osman; Karalök, Alper; Başaran, Derman; Bulbul, Dilek; Turan, Taner

doi:10.1097/igc.0000000000001086

Cited by 27 publications

(38 citation statements)

References 47 publications

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“… 20 Moreover, recent studies have reported that the FIGO stage was an independent prognostic factor for the risk of both recurrence and death. 21 , 22 In our study, patients with stage II cervical cancer showed significantly unfavorable OS (HR 2.320 [95% CI: 1.438–3.745]) compared to patients in stage I (data not shown).…”

Section: Discussionmentioning

confidence: 57%

Vaginal cuff length during radical hysterectomy is a prognostic factor for stage IB-IIA cervical cancer: a retrospective study

Zuo

Thapa

et al. 2018

CMAR

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PurposeThe aim of this study was to investigate the impact of vaginal cuff length (VCL) resected during radical hysterectomy (RH) on the long-term survival outcomes of patients with cervical cancer (International Federation of Gynecology and Obstetrics [FIGO] stage IB–IIA) and to explore whether VCL is a prognostic factor for cervical cancer.MethodsA total of 435 eligible patients with stage IB and IIA cervical cancer who underwent RH in Zhongnan Hospital of Wuhan University (Wuhan, People’s Republic of China) from January 2007 to February 2017 were retrospectively analyzed. These patients were divided into two groups (VCL ≤2.0 cm and >2.0 cm) for further analysis according to the VCL during RH. The Kaplan–Meier method was adopted to calculate the survival rates. Univariate and multivariate Cox regression models were used to analyze independent prognosis factors for survival.ResultsOf the 435 identified patients, 196 had VCL ≤2.0 cm and 239 had VCL >2.0 cm after RH. The 5-year disease-free survival (DFS) for the group who had VCL ≤2.0 cm vs the group who had VCL >2.0 cm was 68.1% vs 87.5% (P<0.001). Correspondingly, the overall survival (OS) for the two groups was 71.4% vs 89.2% (P<0.001). More interestingly, the VCL was significantly associated with the 5-year local recurrence rate, but not associated with the distant metastasis rate. In addition to the VCL, FIGO stage and lymph node involvement were also identified as significant prognostic factors for cervical cancer.ConclusionResection of VCL >2.0 cm in RH has a more favorable long-term outcome than VCL ≤2.0 cm among patients with cervical cancer (FIGO stage IB–IIA); shorter VCL resection was significantly associated with local recurrence, DFS, and OS; thus, it can be considered as a prognostic factor for cervical cancer.

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Section: Discussionmentioning

confidence: 57%

Vaginal cuff length during radical hysterectomy is a prognostic factor for stage IB-IIA cervical cancer: a retrospective study

Zuo

Thapa

et al. 2018

CMAR

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“…Cervical squamous cell carcinoma (CSCC) is the most common primary tumor in the cervical region; other rare primary tumors include clear-cell carcinoma of the cervix (CCCC) and small-cell carcinoma of the cervix (SCCC), [1][2][3] primary lymphoma of the cervix, 4 cervical choriocarcinoma, 5 sarcoma of the uterine cervix, 6 rhabdomyoma of the cervix, 7 malignant melanoma of the cervix, 8,9 Wilm's tumor of the cervix, 10 and malignant peripheral neurilemmoma of cervical broblasts. 11 Regardless of the type of cervical neoplasm, contact hemorrhage or uor sanguinolentus are the main early clinical manifestations; late clinical manifestations include irregular vaginal bleeding of varying amounts with corresponding symptoms of distant metastasis.…”

Section: Introductionmentioning

confidence: 99%

Ultrasonographic Diagnosis of Rare Primary Cervical Cancer

Zheng

et al. 2020

Preprint

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Background: To summarize ultrasonographic features of rare primary and common cervical cancer and the association of these cancers with HPV infection so as to diagnose rare primary cervical cancer.METHODS: Sixty-five cases with cervical cancer suspected by ultrasonography and three cases with clinical symptoms treated at our department underwent cervical biopsy. Sixty-four diagnosed cases were retrospectively analyzed and divided into common-type (CTCC) and rare-type (RTCC) cervical cancers.RESULTS: Sixty-one cases were diagnosed, four misdiagnosed, three missed the diagnosis by ultrasonography, the sensitivity of which was 95.31% (61/64). The common-type cervical cancer had 43 cases of squamous cell carcinoma. The rare-type cervical cancer had 15 cases of adenocarcinoma, four of small-cell carcinoma, and two of adenosquamous carcinoma. The demographic characteristics of the two groups were not significantly different (P > 0.2). The tumor size in RTCC was smaller than those in CTCC (P < 0.05). Hypoechoic lesions in CTCC and isoechoic lesions in RTCC composed 74.42% (32/43) and 61.90% (13/21), respectively (P < 0.001). Exophytic in CTCC and endophytic in RTCC composed 67.44% (29/43) and 66.67% (14/21), respectively (P = 0.01). HPV infection composed 83.72% (36/43) in CTCC and 47.62% (10/21) in RTCC, respectively (P = 0.003). Color Doppler blood signals were found in all cases, as compared with normal cervical tissue. The consistency between ultrasonography and pathology staging diagnosis of RTCC was good (Weighted kappa (95%CI) = 0.87).CONCLUSION: Most of patients in RTCC have isoechoic lesions. There is a good consistency between ultrasonography and pathology staging diagnosis of RTCC.

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“…They occur relatively commonly in the corpus of the uterus but are extremely rare in the cervix, constituting less than 1% of all cervical malignancies . Approximately only 80 cases have been reported in the English literature so far , and 128 cases have been documented according to the National Cancer Institute's Surveillance, Epidemiology, and End Results database . Owing to their rarity, cervical carcinosarcomas have not been well characterized, and currently there is no standard of care for this disease .…”

Section: Introductionmentioning

confidence: 99%

“…Approximately only 80 cases have been reported in the English literature so far , and 128 cases have been documented according to the National Cancer Institute's Surveillance, Epidemiology, and End Results database . Owing to their rarity, cervical carcinosarcomas have not been well characterized, and currently there is no standard of care for this disease . A recent meta‐analysis revealed that the 2‐year disease‐free survival and overall survival were 49% and 60%, respectively .…”

Section: Introductionmentioning

confidence: 99%

“…Owing to their rarity, cervical carcinosarcomas have not been well characterized, and currently there is no standard of care for this disease . A recent meta‐analysis revealed that the 2‐year disease‐free survival and overall survival were 49% and 60%, respectively . Better prognosis was observed in the subgroup of patients with surgery followed by radiotherapy with or without chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

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Exceptional Response of Cryoablation Followed by Pembrolizumab in a Patient with Metastatic Cervical Carcinosarcoma with High Tumor Mutational Burden: A Case Report

Zhu

Liu

et al. 2019

The Oncologist

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Cervical carcinosarcoma is an extremely rare type of neoplasm that lacks standard of care. Preclinical and clinical evidence has suggested that cryoablation in combination with immunotherapy may result in a synergistic effect, generating a more robust immune response to distant lesions. A few clinical trials have evaluated the efficacy of such combination treatment in a variety of solid tumors, but with conflicting results. This report describes the first clinical efficacy of cryoablation followed by pembrolizumab observed in a patient with tumor mutational burden (TMB)-high metastatic cervical carcinosarcoma that was negative for programmed cell death protein 1 expression, microsatellite instability stable, and had mutations in DNA polymerase epsilon (POLE). She had achieved complete response (CR) after 3 months of pembrolizumab treatment and had maintained CR as of the time of submission of this manuscript, with a progression-free survival of 11 months and counting. The case exhibited an exceptional response to cryoablation followed by pembrolizumab, potentially attributed to mutations in POLE, which lead to an extremely high TMB. This report paves the avenue for establishing treatment regimens for patients with TMB-high cervical carcinosarcoma. The Oncologist 2020;25:15-18 KEY POINTS• Owing to its rarity, cervical carcinosarcoma has not been well characterized, and currently, there is no standard of care for this disease. • This report describes the first case of clinical efficacy of cryoablation followed by pembrolizumab observed in a patient with tumor mutational burden-high metastatic cervical carcinosarcoma. • The case exhibited an exceptional response (maintained CR as of the time of submission of this article: 11 months) to cryoablation followed by pembrolizumab. • This is the first POLE-mutated cervical carcinosarcoma case.

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Therapy Modalities, Prognostic Factors, and Outcome of the Primary Cervical Carcinosarcoma: Meta-analysis of Extremely Rare Tumor of Cervix

Abstract: In due course of presentation, the tumor stage has a great importance because it is the only independent factor for prognosis. Surgery followed by adjuvant radiotherapy with or without chemotherapy seems to be related with better OS and DFS.

Cited by 27 publications

References 47 publications

Vaginal cuff length during radical hysterectomy is a prognostic factor for stage IB-IIA cervical cancer: a retrospective study

Vaginal cuff length during radical hysterectomy is a prognostic factor for stage IB-IIA cervical cancer: a retrospective study

Ultrasonographic Diagnosis of Rare Primary Cervical Cancer

Exceptional Response of Cryoablation Followed by Pembrolizumab in a Patient with Metastatic Cervical Carcinosarcoma with High Tumor Mutational Burden: A Case Report

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