Uterine Carcinosarcomas versus Leiomyosarcomas: DuaL Institutional Experience from Mansoura and Zagazig Universities

Objective: Carcinosarcomas (CSs) and leiomyosarcomas (LMSs) are rare uterine cancers with high mortality. This study presents a dual institutional experience from two different university teaching hospitals (Mansoura and Zagazig Universities situated in the Delta of the Nile River in Egypt) with regard to the treatment modalities of those two types of uterine cancers aimed at establishing demographics and treatment outcomes.

Patients & Methods: The data from 12 uterine CS and 17 LMS patients treated at the Clinical Oncology Departments of Mansoura and Zagazig Universities from January 2012 to June 2018 were reviewed to evaluate demographics and treatment outcomes.

Results: The mean age of the patients was greater than 50 years. Abnormal uterine bleeding (AUB) was the most common presenting symptom.

Six CS (50%) patients underwent comprehensive surgical staging, while 4 patients underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH&BSO). Conversely, TAH&BSO was performed in 15 patients with LMS (88%).

Adjuvant radiotherapy was given to 6 CS (50%) and 4 LMS (24%) patients. Meanwhile, adjuvant chemotherapy was received by 5 CS (42%) and 8 LMS (47%) patients. Pelvic failure occurred in only the LMS group. Visceral metastasis occurred in both groups, while bone metastasis was encountered in only the CS group. The overall survival at 5 years was 53% and 32% in patients with CS and LMS, respectively.

Conclusion: AUB should be seriously investigated. Both diseases are aggressive despite early presentation and radical multimodality treatment. Local recurrence was reported in only the LMS group. Visceral metastasis occurred in both groups, unlike bone metastasis. New targeted therapies are urgently needed.