An Update on the Management of Uterine Carcinosarcoma

Carcinosarcomas are rare aggressive neoplasms with a poor prognosis. The recent International Federation of Gynecology and Obstetrics (FIGO) 2009 categorizes uterine carcinosarcoma into the endometrial carcinoma group. This review highlights the prognosis, recurrence rate, and the treatment modalities. The primary treatment is surgery. Lymphadenectomy as part of the surgical procedure has shown to prolong survival even for early-stage disease. A combined chemo-radiotherapeutic approach has shown a survival benefit. Radiotherapy from various studies has shown a significant effect on local control of the disease, with no obvious benefit on overall survival. Various trials led by the gynecologic oncology group looking into different chemotherapeutic combinations have showed differing response rates. In the future, the emergence of combination of chemotherapeutic agents with molecular-targeted agents may show promising results. Target Audience: Obstetricians & Gynecologists and Family Physicians Learning Objectives: After completing this CME activity, physicians should be better able to appraise the aggressive nature of uterine carcinosarcoma and factors which would help in delaying or preventing recurrence, assess the importance of lymphadenectomy for uterine carcinosarcoma and its effect on survival, and evaluate various recent trials addressing the chemo-radiotherapeutic combinations as adjuvant therapy.