Abstract / Description of output
BACKGROUND: Ovarian carcinosarcoma (OCS) is an uncommon, biphasic and highly aggressive ovarian cancer type, which has received relatively little research attention.
METHODS: We curated the largest pathologically-confirmed OCS cohort to date, performing detailed histopathological characterisation, analysis of features associated with survival, and comparison against high grade serous ovarian carcinoma (HGSOC).
RESULTS: 82 OCS patients were identified; overall survival was poor (median 12.7 months). 79% demonstrated epithelial components of high grade serous (HGS) type, while 21% were endometrioid. Heterologous elements were common (chondrosarcoma in 32%, rhabdomyosarcoma in 21%, liposarcoma in 2%); chondrosarcoma was more frequent in OCS with endometrioid carcinomatous
components. Earlier stage, complete resection, and platinum-containing adjuvant chemotherapy were associated with prolonged survival; however, risk of relapse and mortality was high across all patient groups. Histological subclassification did not identify subgroups with distinct survival. Compared to HGSOC, OCS patients were older (P<0.0001), more likely to be FIGO stage I (P=0.025), demonstrated lower chemotherapy response rate (P=0.001) and had significantly poorer survival (P<0.0001).
CONCLUSION: OCS represents a distinct, highly lethal form of ovarian cancer for which new treatment strategies are urgently needed. Histological sub-classification does not identify patient subgroups with distinct survival. Aggressive adjuvant chemotherapy should be considered for all cases, including those with early stage disease.
METHODS: We curated the largest pathologically-confirmed OCS cohort to date, performing detailed histopathological characterisation, analysis of features associated with survival, and comparison against high grade serous ovarian carcinoma (HGSOC).
RESULTS: 82 OCS patients were identified; overall survival was poor (median 12.7 months). 79% demonstrated epithelial components of high grade serous (HGS) type, while 21% were endometrioid. Heterologous elements were common (chondrosarcoma in 32%, rhabdomyosarcoma in 21%, liposarcoma in 2%); chondrosarcoma was more frequent in OCS with endometrioid carcinomatous
components. Earlier stage, complete resection, and platinum-containing adjuvant chemotherapy were associated with prolonged survival; however, risk of relapse and mortality was high across all patient groups. Histological subclassification did not identify subgroups with distinct survival. Compared to HGSOC, OCS patients were older (P<0.0001), more likely to be FIGO stage I (P=0.025), demonstrated lower chemotherapy response rate (P=0.001) and had significantly poorer survival (P<0.0001).
CONCLUSION: OCS represents a distinct, highly lethal form of ovarian cancer for which new treatment strategies are urgently needed. Histological sub-classification does not identify patient subgroups with distinct survival. Aggressive adjuvant chemotherapy should be considered for all cases, including those with early stage disease.
| Original language | English |
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| Journal | British Journal of Cancer |
| Early online date | 17 Jun 2022 |
| DOIs | |
| Publication status | E-pub ahead of print - 17 Jun 2022 |