Risk factors and treatment strategies for female reproductive system carcinosarcoma with metastasis.

Abstract

Background: Carcinosarcomas are rare, aggressive tumors of the female reproductive tract, with limited knowledge regarding their progression, metastasis, risk factors, and treatment, especially in advanced stages. This study aimed to investigate the risk factors and treatment outcomes for metastatic carcinosarcoma using a population-based approach.

Methods: A retrospective study based on the Surveillance, Epidemiology, and End Results (SEER) database was conducted in order to identify patients diagnosed with carcinosarcoma and to analyze metastatic trends and patterns. Chi-square tests, Cox regression models, and the Kaplan-Meier method were used to identify risk factors and to assess the outcomes of various treatment strategies.

Results: A total of 6,479 patients with carcinosarcoma were identified, with an estimated median cancer-specific survival (CSS) of 29 months. There were 775 patients in the metastatic cohort, with an estimated median CSS of 9 months. The metastasis patterns were mostly one-site metastasis (N=318, 41.03%), and the most common metastases were lung metastasis (N=153, 19.74%), followed by liver metastasis (N=96, 12.39%). A range of variables such as age, race, marital status, stage, grade, and size were found to be risk factors for metastatic carcinosarcoma in the univariable Cox model, but only tumor size was found to be an independent risk factor in the multivariable Cox model. Surgery and chemotherapy were associated with significant increases in survival, but radiotherapy was not.

Conclusions: Carcinosarcoma is rare but aggressive and often results in lung and liver metastases. We conclude from our analysis that tumor size is an independent prognostic risk factor in patients with metastases, and we recommend both surgery and chemotherapy for these patients.