Ovarian carcinosarcoma is a distinct form of ovarian cancer with poorer survival compared to tubo-ovarian high grade serous

Robb Hollis*, Ian Croy, Michael Churchman, Clare Bartos, Tzyvia Rye, Charlie Gourley, C Simon Herrington

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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.
Original languageEnglish
JournalBritish Journal of Cancer
Early online date17 Jun 2022
Publication statusE-pub ahead of print - 17 Jun 2022


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