Analysis of the incidence, diagnosis, and treatment of endometrial carcinosarcoma in patients from 2013 to 2024
Drin I.T.1,2, Vytrykhovska I.V.2, Davydiuk S.S.1,2, Kryzhanivska A.Y.1,2
- 1Ivano-Frankivsk National Medical University, Ukraine
- 2Municipal Nonprofit Enterprise «Prykarpattia Clinical Oncology Center of the Ivano-Frankivsk Regional Council», Ukraine
Summary. Endometrial carcinosarcoma (ECS) is a rare and aggressive tumor that combines features of both epithelial and mesenchymal malignant growth. It currently accounts for approximately 5% of all malignant uterine body tumors. Despite its relatively low incidence, ECS is responsible for up to 40% of deaths associated with endometrial cancer. The disease is often diagnosed at an advanced stage and is characterized by a high recurrence rate, even when detected early. Materials and methods. This study presents a retrospective analysis of 51 patients diagnosed with stages I–IV ECS who were treated at the Prykarpattia Clinical Oncology Center of the Ivano-Frankivsk Regional Council between 2013 and 2024. The analysis included patient age distribution, cancer stage at diagnosis, surgical approach, and features of adjuvant treatment. Patient ages ranged from 50 to 87 years, with a mean age of 66.3±1.2 years. The majority of patients (43%) were in the 61–69 age group. Results. The most frequently diagnosed stages were IIIA–IIIC (35%) and IVA–IVB (30%), indicating late-stage detection. In 73% of cases, the diagnosis was confirmed only after surgery. Total hysterectomy with bilateral salpingo-oophorectomy was performed in 35% of cases; the same operation combined with radical pelvic lymphadenectomy was carried out in 45%; and primary cytoreductive surgery was performed in 20% of patients. Adjuvant chemotherapy was administered to 53% of patients, while combined chemoradiation therapy was used in 47%, mostly in advanced stages. Pelvic lymph node involvement was found in 29% of cases, and implantation metastases in 16%. Among tumors with a determined differentiation grade (n=25), 48% were poorly differentiated (G3), and 32% were undifferentiated (G4). Conclusions. The findings indicate a high degree of malignancy in endometrial carcinosarcomas and underscore the need for aggressive, individualized treatment using a multimodal approach, even in patients with early-stage disease.
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