Wu Huijie, Huo Peiqiong, Dong Miao, Xiao Ying, Tu Lewei
School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China.
Faculty of Medicine, Macau University of Science and Technology, Macau, China.
Transl Cancer Res. 2025 Aug 31;14(8):4748-4758. doi: 10.21037/tcr-2025-697. Epub 2025 Aug 25.
Carcinosarcomas are rare, aggressive tumors of the female reproductive tract, with limited knowledge regarding their progression, metastasis, risk factors, and treatment, especially in advanced stages. This study aimed to investigate the risk factors and treatment outcomes for metastatic carcinosarcoma using a population-based approach.
A retrospective study based on the Surveillance, Epidemiology, and End Results (SEER) database was conducted in order to identify patients diagnosed with carcinosarcoma and to analyze metastatic trends and patterns. Chi-square tests, Cox regression models, and the Kaplan-Meier method were used to identify risk factors and to assess the outcomes of various treatment strategies.
A total of 6,479 patients with carcinosarcoma were identified, with an estimated median cancer-specific survival (CSS) of 29 months. There were 775 patients in the metastatic cohort, with an estimated median CSS of 9 months. The metastasis patterns were mostly one-site metastasis (N=318, 41.03%), and the most common metastases were lung metastasis (N=153, 19.74%), followed by liver metastasis (N=96, 12.39%). A range of variables such as age, race, marital status, stage, grade, and size were found to be risk factors for metastatic carcinosarcoma in the univariable Cox model, but only tumor size was found to be an independent risk factor in the multivariable Cox model. Surgery and chemotherapy were associated with significant increases in survival, but radiotherapy was not.
Carcinosarcoma is rare but aggressive and often results in lung and liver metastases. We conclude from our analysis that tumor size is an independent prognostic risk factor in patients with metastases, and we recommend both surgery and chemotherapy for these patients.
癌肉瘤是女性生殖道罕见的侵袭性肿瘤，人们对其进展、转移、危险因素及治疗的了解有限，尤其是在晚期。本研究旨在采用基于人群的方法调查转移性癌肉瘤的危险因素和治疗结果。
基于监测、流行病学和最终结果（SEER）数据库进行了一项回顾性研究，以识别诊断为癌肉瘤的患者，并分析转移趋势和模式。使用卡方检验、Cox回归模型和Kaplan-Meier方法来识别危险因素并评估各种治疗策略的结果。
共识别出6479例癌肉瘤患者，估计癌症特异性生存（CSS）中位数为29个月。转移性队列中有775例患者，估计CSS中位数为9个月。转移模式大多为单部位转移（N = 318，41.03%），最常见的转移部位是肺转移（N = 153，19.74%），其次是肝转移（N = 96，12.39%）。在单变量Cox模型中，年龄、种族、婚姻状况、分期、分级和大小等一系列变量被发现是转移性癌肉瘤的危险因素，但在多变量Cox模型中，仅肿瘤大小被发现是独立危险因素。手术和化疗与生存率显著提高相关，但放疗并非如此。
癌肉瘤罕见但具有侵袭性，常导致肺和肝转移。我们从分析中得出结论，肿瘤大小是转移患者的独立预后危险因素，我们建议对这些患者同时进行手术和化疗。
