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Abstract：
OBJECTIVE: 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).
CONCLUSIONS: 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.
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).
CONCLUSIONS: 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.
摘要：
目的：子宫癌肉瘤（UCSs）是侵袭性双相恶性肿瘤，具有癌/上皮成分和肉瘤/间充质成分。这项研究的目的是评估肉瘤成分（同源与异源）对总生存期（OS）和无进展生存期（PFS）的影响。
方法：这是一项针对I期和II期UCSs患者进行的多中心观察性回顾性研究。
结果：检索到95例经组织学诊断为早期UCSs的妇女：60例（63.2％）肿瘤具有同源肉瘤成分，和35（36.8％）与异源。在单变量分析中，基质侵入≥50%,透明细胞的存在，浆液性或未分化的癌成分，异源肉瘤成分和FIGO阶段IB和II被证明是对PFS具有统计学显著负面影响的变量。同样，侵入深度≥50%,异源肉瘤成分和FIGOIB期和II期也是与OS相关的统计学阴性预后因素.在多变量分析中，在PFS(HR2.362,95%CI1.207-4.623,p值=0.012)和OS(HR1.950,95%CI1.032-3.684,p=0.040)上,只有异源肉瘤成分被证实是统计学上显著的阴性预后因素.
结论：癌性和肉瘤性成分均在肿瘤进展和患者生存中起作用。然而,在多变量模型中,只有肉瘤成分保留了统计学意义,提示其在早期UCSs中具有突出的预后作用.
方法：这是一项针对I期和II期UCSs患者进行的多中心观察性回顾性研究。
结果：检索到95例经组织学诊断为早期UCSs的妇女：60例（63.2％）肿瘤具有同源肉瘤成分，和35（36.8％）与异源。在单变量分析中，基质侵入≥50%,透明细胞的存在，浆液性或未分化的癌成分，异源肉瘤成分和FIGO阶段IB和II被证明是对PFS具有统计学显著负面影响的变量。同样，侵入深度≥50%,异源肉瘤成分和FIGOIB期和II期也是与OS相关的统计学阴性预后因素.在多变量分析中，在PFS(HR2.362,95%CI1.207-4.623,p值=0.012)和OS(HR1.950,95%CI1.032-3.684,p=0.040)上,只有异源肉瘤成分被证实是统计学上显著的阴性预后因素.
结论：癌性和肉瘤性成分均在肿瘤进展和患者生存中起作用。然而,在多变量模型中,只有肉瘤成分保留了统计学意义,提示其在早期UCSs中具有突出的预后作用.
