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abstract
Highlights
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- Ovarian carcinosarcoma has worse prognosis compared to papillary serous histology.
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- The survival difference was noted across all FIGO stages.
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- Women with ovarian carcinosarcoma are less likely to receive chemotherapy.
Objective
The
aim of this study is to determine if outcomes of patients with ovarian
carcinosarcoma (OCS) differ from those of women with high-grade
papillary serous ovarian carcinoma (HG-PSOC) when compared by stage and
treatment modalities.
Methods
The
National Cancer Database was queried to identify patients with OCS and
HG-PSOC diagnosed between 2003 and 2011. Demographic and clinical data
were compared, and the impact of tumor histology on survival was
analyzed using the Kaplan–Meier method. Factors predictive of outcome
were compared using the Cox proportional hazards model.
Results
The
final study group consisted of 45,153 women. 2886 (6.39%) had OCS and
42,267 (93.61%) had HG-PSOC. The mean age at diagnosis was 65.43
(± 12.21) years for women with OCS and 61.52 (± 12.6) years for HG-PSOC
(P < 0.001). African-American women had higher rate of OCS relative
to white non-hispanic women (7.84% vs. 6.37%; P = 0.002). Overall, women
with OCS had a worse five-year survival rate, 26.63% [95% Confidence
Interval (CI) = 24.86%–28.53%] vs. 43.61% (95% CI = 43.07%–44.17%). This
difference persisted for each FIGO disease stage I–IV, with five-year
survival consistently worse for women with OCS compared to those with
HG-PSOC. Over the entire study period and after adjusting for histology,
age, period of diagnosis, SEER registry, marital status, stage,
surgery, radiotherapy, and lymph node dissection, carcinosarcoma
histology was associated with decreased survival.
Conclusion
OCS is associated with a poor prognosis compared to HG-PSOC. This difference was noted across all FIGO stages.
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