Carboplatin and Paclitaxel versus Doxorubicin and Cisplatin for Carcinosarcoma of the Uterus: A historical cohort with control based on FIGO 2009 criteria from the University of Manitoba
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Objectives: To compare two different chemotherapy adjuvant treatment regimens currently and previously used at CancerCare Manitoba for endometrial carcinosarcoma. Methods: This is a retrospective analysis of 60 patients diagnosed with primary endometrial carcinosarcoma at CancerCare Manitoba from 1998-2008. The demographic characteristics, malignancy stage, presence of recurrent disease, and treatment type(s) utilized were studied. 37 patients were found to have received either carboplatin/paclitaxel or doxorubicin/cisplatin for carcinosarcoma, and were further analyzed to determine if there was a statistically significant difference in progression-free survival and overall survival between the two treatments. Kaplan-Meier curves were used to display progression-free survival and overall survival. Results: 60.4% of patients presented with low-stage disease. No statistically significant difference in progression-free survival or overall survival between the two cohorts was found. Recurrence rate was 31.7%. The mean time to recurrence in the combined cohorts was 23.2 months. 16.7% of the patients had or were currently being treated with tamoxifen. 73.7% of patients having recurrence did not undergo lymph node dissections and 100% of patients with local recurrence were treated with vaginal vault brachytherapy. Conclusions: Due to the rarity of this malignancy, multi-centre studies are warranted based on the data collected as sample sizes were too small for statistical significance. Further investigations towards optimizing treatment and understanding disease associations should be performed in the future to help better manage these patients and improve survival.