Objective: To investigate the clinicopathological characteristics, treatment and prognosis of head and neck carcinosarcoma. Methods: The clinical data of 14 patients with head and neck carcinosarcoma treated in the First Affiliated Hospital of Zhengzhou University from January 2010 to May 2020 were retrospectively analyzed, including 11 males and 3 females, with age range from 30 to 72 years old. Clinicopathological characteristics, treatments and follow-up results of patients were evaluated. Kaplan-Meier method was used to estimate the cumulative survival rate. Results: Histopathological examination showed the co-existence of malignant epithelial and mesenchymal components in all cases. Immunohistochemical staining of 13 cases showed cytokeratin and epithelial membrane antigens were positively expressed in the epithelial areas, whereas vimentin was positive in the malignant mesenchymal tissue area. Among 14 cases, 5 cases were treated with surgery, 3 cases with surgery and radiotherapy, and 6 cases with surgery, radiotherapy and chemotherapy. The follow-up time was 2-81 months, with a median follow-up time of 22.5 months. Except for one patient who was lost to follow-up in 21 months after treatment, among the remaining 13 patients, 4 patients had recurrence, 8 patients died, and 5 patients had a tumor-free survival. The Kaplan-Meier analysis showed that the 1, 3, and 5-year cumulative survival rates of 14 patients with head and neck carcinosarcoma were 64.3%, 57.1%, and 42.9%, respectively. Conclusions: Carcinosarcoma of the head and neck is rare in clinic, histopathological and immunohistochemical examinations are important basis for diagnosis, and surgery is a preferred treatment. Carcinosarcoma of the head and neck has a poor prognosis, and patients should be followed up for a long time.
Adult ; Aged ; Carcinosarcoma/therapy* ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Prognosis ; Retrospective Studies

OBJECTIVE: Uterine carcinosarcoma (UCS) shared the same staging system with endometrial carcinoma in the International Federation of Gynecology and Obstetrics 2009. The aim of the present study was to compare the clinicopathological and prognostic characteristics between UCS and grade 3 endometrioid endometrial carcinoma (G3EC). METHODS: A retrospective analysis of 60 UCS and 115 G3EC patients with initial treatment at the Department of Gynecology in the Fudan University Shanghai Cancer Center between February 2006 and August 2013. Chi-square analysis was used to compare differences between variables. Prognostic factors were determined using univariate/multivariate analysis, and the survival rates were assessed using the Kaplan-Meier method. The Cox regression model was used to assess the independent prognostic factor. RESULTS: UCS had significantly worse overall survival (OS) compared with G3EC. Carcinosarcoma subtype was an independent factor (hazard ratio [HR], 2.4; 95% confidence interval [CI], 1.0 to 5.8; p=0.039), stratified based on stage. Compared with G3EC, UCS patients had a greater incidence of ascites fluid (55.0% vs. 15.7%, p<0.001) and adnexal involvement (20.0% vs. 8.7%, p=0.048) and larger median tumor volume (4.6 cm vs. 4.0 cm, p=0.046). Subgroup analysis of the prognostic factors revealed that UCS patients exhibited worse OS than G3EC patients in such specific subgroups as patients at younger ages, with postmenopausal status, without ascites fluid, with early stage diseases, without vagina invasion, without lymph node metastases and receiving adjuvant chemo/radiotherapy. Adjuvant radiotherapy with chemotherapy was predictive of better survival in UCS patients compared with chemotherapy or radiotherapy alone (5-year OS, 71.0% vs. 35.8%, p=0.028). Multivariate Cox regression revealed that tumor mesenchymal component (HR, 4.6; 95% CI, 1.4 to 15.8; p=0.014) was an independent prognostic factor for UCS, whereas advanced stages (HR, 5.9; 95% CI, 1.0 to 33.9; p=0.046) and ascites fluid (HR, 5.1; 95% CI, 1.1 to 22.7; p=0.032) were independently correlated with poor prognosis for G3EC patients. CONCLUSION: The distinctions in both clinicopathological and prognostic characteristics between UCS and G3EC suggest that this subtype should be treated separately from high-risk epithelial endometrial carcinoma.
Adnexa Uteri/pathology ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Aorta ; Ascites/etiology ; Carcinoma, Endometrioid/*secondary/*therapy ; Carcinosarcoma/*secondary/*therapy ; Chemotherapy, Adjuvant ; Cytoreduction Surgical Procedures ; Endometrial Neoplasms/*pathology/*therapy ; Female ; Humans ; Hysterectomy ; *Lymph Node Excision ; Lymphatic Metastasis ; Middle Aged ; Neoplasm Grading ; Neoplasm Invasiveness ; Neoplasm Staging ; Pelvis ; Postmenopause ; Radiotherapy, Adjuvant ; Retrospective Studies ; Survival Rate ; Tumor Burden ; Vagina/pathology

No abstract available.
Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms/*epidemiology/genetics ; Carcinosarcoma/*epidemiology/genetics ; Cohort Studies ; England/epidemiology ; Female ; Genes, BRCA1 ; Genes, BRCA2 ; Hormone Replacement Therapy/*statistics & numerical data ; Humans ; Incidence ; Kaplan-Meier Estimate ; Middle Aged ; Mixed Tumor, Mullerian/*epidemiology/genetics ; Mutation/genetics ; Neoplasms, Second Primary/*epidemiology ; Uterine Neoplasms/*epidemiology/genetics

Carcinosarcomas of the uterine cervix are extremely rare. Cervical carcinosarcoma can be characterized by having two different origins: the Mullerian ducts and the mesonephric duct remnants. A 53-year-old Korean woman was admitted to the hospital because of pelvic mass detected on computed tomography scan done at private clinic. A Radical hysterectomy with bilateral salpingooophorectomy and pelvic lymphadenectomy was carried out upon a diagnosis of stage IB2 cervical sarcoma. Immunohistochemically, the epithelial component was positive for pancytokeratin and estrogen receptor, but negative for CD 10 and carletinin. The mesenchymal component was positive for vimentin. The histopathologic diagnosis was a carcinosarcoma of the uterine cervix arising from Mullerian ducts. She underwent chemotherapy. She developed systemic recurrence seven months after operation and died of disease. The origin of cervical carcinosarcoma needs to be verified and immunohistochemical studies using mesonephric marker (CD 10, carletinin, and estrogen receptor) is helpful.
Breast Neoplasms ; Carcinosarcoma* ; Cervix Uteri* ; Diagnosis ; Drug Therapy ; Estrogens ; Female ; Humans ; Hysterectomy ; Lymph Node Excision ; Middle Aged ; Mullerian Ducts* ; Recurrence ; Sarcoma ; Vimentin ; Wolffian Ducts

Esophageal carcinosarcoma is a rare malignant esophageal neoplasm consisting of both carcinomatous and sarcomatous elements, with an incidence of 0.5%. There have been only a few case reports of carcinosarcoma and squamous cell carcinoma coexisting in the esophagus. However, all of these are cases of synchronous or metachronous development of carcinosarcoma after chemoradiotherapy in patients of esophageal squamous cell carcinoma. A 53-year-old man underwent esophagogastroduodenoscopy because of chest pain for several months. Endoscopic examination revealed a huge pedunculated esophageal polypoid mass. Endoscopic submucosal dissection (ESD) was performed and histopathologic examination confirmed spindle cell carcinoma (carcinosarcoma). He refused additional esophagectomy. After 21 months, third follow-up endoscopy showed poorly-demarcated flat, faint discolored lesions at different location from the previous ESD site and endoscopic biopsies confirmed squamous cell carcinoma. To the best of our knowledge, this is the first case of metachronous development of esophageal squamous cell carcinoma in a patient with esophageal carcinosarcoma.
Antineoplastic Agents/therapeutic use ; Carcinoma, Squamous Cell/*diagnosis/drug therapy/pathology ; Carcinosarcoma/*diagnosis/drug therapy/pathology ; Cisplatin/therapeutic use ; Drug Therapy, Combination ; Endoscopy, Digestive System ; Esophageal Neoplasms/*diagnosis/drug therapy/pathology ; Fluorouracil/therapeutic use ; Humans ; Male ; Middle Aged ; Positron-Emission Tomography ; S100 Proteins/metabolism ; Tomography, X-Ray Computed ; Tumor Suppressor Protein p53/metabolism

OBJECTIVETo improve the recognition, appropriate diagnosis and treatment of breast carcinosarcoma through analysis of their clinical features, diagnosis, management and prognosis.

METHODSThe clinicopathological data from 25 patients with breast carcinosarcoma treated in our hospital between January 1976 and January 2008 were retrospectively reviewed. The correlation between prognosis and age, tumor size, axillary node status, and treatment modality was analyzed using the statistical software SPSS 13.0. The survival rate was calculated by Kaplan-Meier analysis and compared using log-rank test. Univariate and multivariate factors for survival were analyzed using Cox proportional hazards regression model.

RESULTSAll patients were female and their median age was 56-years. The median tumor diameter was 5.1 cm. The misdiagnosis rate was high by mammography, B-ultrasound and pathological examination of needle aspiration biopsy before operation. So that the diagnosis primarily depended on postoperative histopathologic examination. The ER/PR and HER-2 positive rate of the breast carcinosarcomas was 8.3% and 7.7%, respectively. Invasive ductal carcinoma was the main malignant component accounting for 92.3%, while the sarcoma element was constitutive of fibrosarcoma with a proportion of 46.2%. The overall 5-year survival rate was 57.9% with a median survival time of 86 months after a median follow-up of 52 months. Univariate factor analysis showed that the tumor size (P = 0.012) and treatment methods (P = 0.028) were impact factors, while age and axillary lymph node status were not significantly related with prognosis. Cox multivariate analysis validated that the therapy modality was an independent prognostic factor for breast carcinosarcoma (P = 0.047).

CONCLUSIONSBreast carcinosarcoma is rare and its clinical features are not specific, so that its final diagnosis is mainly based on the postoperative pathology. Tumor size and treatment modality are independent prognostic factors, so the comprehensive therapy mainly based on radical resection is the best treatment modality. The positive expression of ER/PR and HER-2 in breast carcinosarcoma is low, while exploring new target is one of future research directions.

Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms ; metabolism ; pathology ; therapy ; Carcinosarcoma ; metabolism ; pathology ; therapy ; Chemotherapy, Adjuvant ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; secondary ; Mastectomy ; methods ; Middle Aged ; Neoplasm Recurrence, Local ; Radiotherapy, Adjuvant ; Receptor, ErbB-2 ; metabolism ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism ; Retrospective Studies ; Survival Rate ; Tumor Burden

OBJECTIVETo analyze the clinicopathological characteristics and prognosis of a rare histological type of esophageal cancer-sarcomatoid carcinoma.

METHODSClinicopathological data of 31 patients with esophageal sarcomatoid carcinoma who underwent surgery in the Department of Thoracic Surgery of Zhejiang Cancer Hospital from Jan 2000 to Dec 2009 were collected and analyzed. The survival analysis was performed using Kaplan-Meier method.

RESULTSAll the patients underwent surgery. Of the 31 patients, one received preoperative chemoradiotherapy and postoperative chemotherapy, and 8 received postoperative chemotherapy. All the tumors were located in the middle or lower esophagus. Microscopically, the tumors were composed of both carcinomatous and sarcomatous components, and there was a transition between the two components, but no obvious heterogenous elements such as osteosarcoma, chondrosarcoma or rhabdomyosarcoma were found. In the carcinomatous components, positive expression of CK and EMA was found in all the 31 cases, and positive expression of vimentin in 5 of the 31 cases. In the sarcomatous components, positive expression of CK, EMA and vimentin was found in 29, 28 and 23 cases, respectively. The 1-, 3-, and 5-year survival rates were 80.6%, 55.9% and 33.4%, respectively, and the median survival time was 40 months.

CONCLUSIONSEsophageal sarcomatoid carcinoma is a particular type of esophageal malignancy with unique clinicopathological features. The diversity and complexity of the carcinomatous and sarcomatous components and their potential of transformation and differentiation lead to different prognosis from each other.

Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinosarcoma ; metabolism ; pathology ; surgery ; therapy ; Chemoradiotherapy, Adjuvant ; Chemotherapy, Adjuvant ; Esophageal Neoplasms ; metabolism ; pathology ; surgery ; therapy ; Esophagectomy ; methods ; Female ; Follow-Up Studies ; Humans ; Keratins ; metabolism ; Male ; Middle Aged ; Mucin-1 ; metabolism ; Prognosis ; Survival Rate ; Vimentin ; metabolism

OBJECTIVETo evaluate the clinical pathological characteristics, treatment and prognosis of ovarian carcinosarcoma.

METHODSThe clinical, pathological and follow-up data of 12 cases of ovarian carcinosarcoma treated in Cancer Center of Sun Yat-sen University from May, 2002 to May, 2009 were analyzed retrospectively.

RESULTSThe 12 patients with ovarian carcinosarcoma had a median age of 55 years at diagnosis, among whom 10 were postmenopausal women. The patients sought medical attention for such symptoms as pelvic and/or abdominal pain, abdominal distention and ascites. Ten patients showed elevated serum CA125 level ad admission, and postoperative chemotherapy resulted in lowered CA125 level within normal range in 7 of them; in 8 cases, CA125 level increased with disease recurrence. Pelvic mass was found by such imaging examinations as CT, MRI and ultrasound in all cases. A definite diagnosis was obtained by postoperative pathological examination. All the patients received surgical resection and platinum-based adjuvant chemotherapy. Two patients achieved disease-free survival after the treatment. Disease relapse occurred in 10 cases within 2 years after surgery, among whom 2 showed disease remission after a secondary surgery and/or chemotherapy, and 1 was receiving chemotherapy; death occurred in 5 cases, and 2 cases were lost to the follow-up.

CONCLUSIONSOvarian carcinosarcoma has a poor prognosis. Primary surgery and platinum-based postoperative adjuvant chemotherapy is the main treatment for ovarian carcinosarcoma. The prognosis of ovarian carcinosarcoma is associated with the residual disease after surgery. The patients with disease recurrence may obtain remission and survival through a secondary surgery and/or chemotherapy. Serum CA125 can be used as a marker for monitoring the chemotherapeutic effect in clinical observation and follow-up visits.

Aged ; CA-125 Antigen ; blood ; Carcinosarcoma ; diagnosis ; therapy ; Female ; Humans ; Membrane Proteins ; blood ; Middle Aged ; Ovarian Neoplasms ; diagnosis ; therapy ; Prognosis ; Retrospective Studies

The Gynecologic Oncology Group (GOG) has conducted multiple trials related to malignancies of the uterine corpus. Recently, several of these trials have been presented and/or published. Areas of focus included the feasibility of laparoscopic staging for endometrial cancer, the adjuvant management of locally advanced endometrial cancer, whole abdominal irradiation in maximally resected advanced endometrial carcinoma, and combination chemotherapy regimens for stage I and II carcinosarcoma after primary surgery and for advanced or recurrent carcinosarcoma. This article will discuss the background and details of each of these important advances.
Carcinosarcoma ; Drug Therapy, Combination ; Endometrial Neoplasms ; Female

The Gynecologic Oncology Group (GOG) has conducted multiple trials related to malignancies of the uterine corpus. Recently, several of these trials have been presented and/or published. Areas of focus included the feasibility of laparoscopic staging for endometrial cancer, the adjuvant management of locally advanced endometrial cancer, whole abdominal irradiation in maximally resected advanced endometrial carcinoma, and combination chemotherapy regimens for stage I and II carcinosarcoma after primary surgery and for advanced or recurrent carcinosarcoma. This article will discuss the background and details of each of these important advances.
Carcinosarcoma ; Drug Therapy, Combination ; Endometrial Neoplasms ; Female