Department of Gynecological Oncology, Aberdeen Royal Infirmary, Aberdeen, United Kingdom.
Obstet Gynecol Surv. 2011 Nov;66(11):710-6. doi: 10.1097/OGX.0b013e31823e0c44.
Carcinosarcomas are rare aggressive neoplasms with a poor prognosis. The recent International Federation of Gynecology and Obstetrics (FIGO) 2009 categorizes uterine carcinosarcoma into the endometrial carcinoma group. This review highlights the prognosis, recurrence rate, and the treatment modalities. The primary treatment is surgery. Lymphadenectomy as part of the surgical procedure has shown to prolong survival even for early-stage disease. A combined chemo-radiotherapeutic approach has shown a survival benefit. Radiotherapy from various studies has shown a significant effect on local control of the disease, with no obvious benefit on overall survival. Various trials led by the gynecologic oncology group looking into different chemotherapeutic combinations have showed differing response rates. In the future, the emergence of combination of chemotherapeutic agents with molecular-targeted agents may show promising results.
Obstetricians & Gynecologists and Family Physicians.
After completing this CME activity, physicians should be better able to appraise the aggressive nature of uterine carcinosarcoma and factors which would help in delaying or preventing recurrence, assess the importance of lymphadenectomy for uterine carcinosarcoma and its effect on survival, and evaluate various recent trials addressing the chemo-radiotherapeutic combinations as adjuvant therapy.
癌肉瘤是一种罕见的侵袭性肿瘤，预后不良。最近国际妇产科联盟（FIGO）2009 将子宫癌肉瘤归类为子宫内膜癌组。这篇综述强调了预后、复发率和治疗方式。主要治疗方法是手术。作为手术程序的一部分进行淋巴结切除术已显示出可延长生存时间，即使是早期疾病。联合化疗和放疗方法已显示出生存获益。来自各种研究的放疗已显示出对疾病局部控制有显著效果，但对总生存无明显益处。妇科肿瘤学组进行的各种试验研究了不同的化疗联合方案，显示出不同的反应率。未来，联合化疗药物和分子靶向药物的出现可能会显示出有希望的结果。
妇产科医生和家庭医生。
完成这项 CME 活动后，医生应该能够更好地评估子宫癌肉瘤的侵袭性特征以及有助于延迟或预防复发的因素，评估淋巴结切除术对子宫癌肉瘤及其对生存的影响，并评估各种最近的试验，这些试验涉及辅助治疗的化疗和放疗联合方案。
