Adjuvant chemotherapy in patients with uterine carcinosarcoma: a review of clinical outcomes and considerations

Abstract

ABSTRACT Introduction Uterine carcinosarcoma (UCS) is a highly aggressive disease, and had been traditionally recognized as a uterine sarcoma. In recent years, it has been categorized as a subtype of high-grade endometrial cancer. Its prognosis is extremely poor, and approximately half of the patients with early-stage disease will recure and eventually die. Due to its high relapse rate, an effective adjuvant therapy is needed. As UCS has a high incidence of distant recurrence, systemic chemotherapy may be beneficial as an adjuvant therapy even in completely resected early-stage cases. A search of PubMed database was performed for research articles published between January 1981 and January 2022. Areas covered We have summarized the current evidence of adjuvant chemotherapy in patients with UCS. Expert opinion There have been only a limited number of prospective randomized trials which enrolled solely carcinosarcoma, particularly with only adjuvant chemotherapy. Several trials have suggested that adjuvant chemotherapy is effective for both early and advance stage. Regarding the chemotherapy regimens, combination chemotherapies including either platinum or ifosfamide are all effective as an adjuvant chemotherapy. Among these, currently paclitaxel plus carboplatin is considered the most preferred regimen in terms of efficacy and toxicity profile.