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Journal of Clinical Oncology : Official... Mar 2022
Topics: Antineoplastic Combined Chemotherapy Protocols; Carboplatin; Carcinosarcoma; Female; Humans; Paclitaxel; Uterine Neoplasms
PubMed: 35044808
DOI: 10.1200/JCO.21.02667 -
Archivos Espanoles de Urologia Sep 2018To report a new case of prostatic carcinosarcoma, an uncommon and locally and distance aggressive tumor.
OBJECTIVE
To report a new case of prostatic carcinosarcoma, an uncommon and locally and distance aggressive tumor.
METHOD
We analyzed one case diagnosed in our Center, from clinical and pathological diagnosis to death, describing the treatments received.
RESULT
Patient presented a huge pelvic mass and a pulmonary metastasis that was treated with cystoprostatectomy and bilateral cutaneous ureterostomy with the diagnosis of carcinosarcoma of the prostate. He received 8 cycles of Docetaxel with bone progression and then 3 cycles of doxorubicin, suspending treatment due to progression. The survival was 18 months.
CONCLUSIONS
Prostate carcinosarcoma is a very aggressive neoplasia that does not respond to the usual treatments of prostate cancer.
Topics: Aged; Carcinosarcoma; Humans; Male; Prostatic Neoplasms
PubMed: 30198853
DOI: No ID Found -
Current Treatment Options in Oncology Dec 2023Ovarian carcinosarcoma (OCS), also known as a malignant mixed Müllerian tumour (MMMT), is a rare and aggressive form of cancer that accounts for less than 5% of ovarian... (Review)
Review
Ovarian carcinosarcoma (OCS), also known as a malignant mixed Müllerian tumour (MMMT), is a rare and aggressive form of cancer that accounts for less than 5% of ovarian cancers. It is characterized by high morbidity and mortality rates, with a median overall survival (OS) of less than 2 years. Several factors, including advancing age, nulliparity, reduced lactation rates, decreased use of oral contraceptive pills, genetic mutations in BRCA (breast cancer) genes, and the use of assisted reproductive technology, may increase the risk of OCS. Poor prognostic factors include an advanced stage at diagnosis, older age, lymph node metastasis, suboptimal surgical cytoreduction, the presence of heterologous features on histopathology, and increased expression of vascular endothelial growth factor (VEGF), tumour protein p53, and p53 alongside Wilms tumour 1 (WT1). The main treatment approach for OCS is cytoreductive surgery followed by platinum-based chemotherapy, although immunotherapy is showing promise. Homologous recombination deficiency (HRD) testing may enhance outcomes by enabling personalized immunotherapy and targeted therapies for specific patient groups, thereby reducing unnecessary side effects and healthcare costs. However, there is currently a lack of standardised treatment regimens for OCS patients, with most studies consisting of case reports and a shortage of suitable comparator groups. This article aims to provide clinicians with information on the epidemiology, risk factors, prognostic factors, and latest therapeutic advancements in OCS.
Topics: Female; Humans; Tumor Suppressor Protein p53; Vascular Endothelial Growth Factor A; Ovarian Neoplasms; Carcinosarcoma
PubMed: 37938504
DOI: 10.1007/s11864-023-01138-4 -
Cancer Research Dec 2022Ovarian carcinosarcoma (OCS) is an aggressive and rare tumor type with limited treatment options. OCS is hypothesized to develop via the combination theory, with a...
UNLABELLED
Ovarian carcinosarcoma (OCS) is an aggressive and rare tumor type with limited treatment options. OCS is hypothesized to develop via the combination theory, with a single progenitor resulting in carcinomatous and sarcomatous components, or alternatively via the conversion theory, with the sarcomatous component developing from the carcinomatous component through epithelial-to-mesenchymal transition (EMT). In this study, we analyzed DNA variants from isolated carcinoma and sarcoma components to show that OCS from 18 women is monoclonal. RNA sequencing indicated that the carcinoma components were more mesenchymal when compared with pure epithelial ovarian carcinomas, supporting the conversion theory and suggesting that EMT is important in the formation of these tumors. Preclinical OCS models were used to test the efficacy of microtubule-targeting drugs, including eribulin, which has previously been shown to reverse EMT characteristics in breast cancers and induce differentiation in sarcomas. Vinorelbine and eribulin more effectively inhibited OCS growth than standard-of-care platinum-based chemotherapy, and treatment with eribulin reduced mesenchymal characteristics and N-MYC expression in OCS patient-derived xenografts. Eribulin treatment resulted in an accumulation of intracellular cholesterol in OCS cells, which triggered a downregulation of the mevalonate pathway and prevented further cholesterol biosynthesis. Finally, eribulin increased expression of genes related to immune activation and increased the intratumoral accumulation of CD8+ T cells, supporting exploration of immunotherapy combinations in the clinic. Together, these data indicate that EMT plays a key role in OCS tumorigenesis and support the conversion theory for OCS histogenesis. Targeting EMT using eribulin could help improve OCS patient outcomes.
SIGNIFICANCE
Genomic analyses and preclinical models of ovarian carcinosarcoma support the conversion theory for disease development and indicate that microtubule inhibitors could be used to suppress EMT and stimulate antitumor immunity.
Topics: Humans; Female; Epithelial-Mesenchymal Transition; Ovarian Neoplasms; Cell Transformation, Neoplastic; Antineoplastic Agents; Microtubules; Carcinosarcoma; Carcinoma
PubMed: 36206301
DOI: 10.1158/0008-5472.CAN-21-4012 -
The Breast Journal 2022Few cases of carcinosarcoma of the breast have been reported because of its low incidence rate and rapid progression. Seeking effective therapeutic methods becomes...
BACKGROUND
Few cases of carcinosarcoma of the breast have been reported because of its low incidence rate and rapid progression. Seeking effective therapeutic methods becomes urgent in clinical practice. This study was aimed to investigate the clinical characteristics of carcinosarcoma of the breast and to explore proper therapeutic methods for patients with this rare tumor.
METHODS
We conducted a retrospective analysis on 47 patients with carcinosarcoma of the breast receiving treatment in our hospital from 2003 to 2020. Most of these patients received primary surgery followed by adjuvant chemotherapy, while four patients had lumpectomy only. Statistics showed no preference in age and menopausal status of patients.
RESULTS
The overall survival rate and progression-free survival rate of all patients at a median follow-up time of 33 months were 63.8% and 57.4%, respectively. Tumor size at diagnosis and chemotherapy strategies were both significant prognostic factors in reference to disease-free survival (DFS) and overall survival (OS) of the patients (tumor size: =0.023 for DFS and =0.021 for OS; therapeutic method: =0.041 for DFS and =0.024 for OS). N stage at diagnosis was significant only with reference to overall survival of the patients (=0.009). EGFR expression was positive in some patients.
CONCLUSIONS
Our results elucidated that the patients received comprehensive therapy, especially adjuvant chemotherapy was indispensable for better outcomes. Early detection and treatment were necessary for a higher survival rate when the tumor size was less than 5 cm without lymph node metastasis. Prospective outcomes with novel strategies targeting EGFR need to be further investigated.
Topics: Breast Neoplasms; Carcinosarcoma; Chemotherapy, Adjuvant; Disease-Free Survival; ErbB Receptors; Female; Humans; Neoplasm Staging; Prognosis; Prospective Studies; Retrospective Studies
PubMed: 35865143
DOI: 10.1155/2022/3614979 -
Journal of the Formosan Medical... Nov 2021To investigate the prognostic factors and impact of adjuvant treatment on uterine carcinosarcoma (UCS).
PURPOSE
To investigate the prognostic factors and impact of adjuvant treatment on uterine carcinosarcoma (UCS).
METHODS
A retrospective review of UCS patients treated between 2005 and 2019 was conducted. International Federation of Gynecology and Obstetrics (FIGO) 2009 staging system was used. Multivariate stepwise Cox proportional hazard regression models were used to identify the independent predictors of overall survival (OS) and progression-free survival (PFS).
RESULTS
A total of 138 patients were eligible for descriptive analysis. Excluding 12 patients without surgery, 126 patients with adequate clinicopathologic data were included for prognostic analysis. The median follow-up for survivors was 51.8 months. 5-year OS and PFS rates for FIGO stage I, II, III, IV were 64.5% and 51.8%, 60.8% and 57.7%, 47.7% and 45.9%, 5.1% and 4.1%, respectively. By multivariate analysis, six models each for PFS and OS were formulated including highly correlated variables alternatively. Adjuvant chemoradiation was consistently selected as an independent prognostic factor for OS (hazard ratio [HR] 0.10-0.22, all p < 0.001) and PFS (HR 0.12-0.23, all p < 0.001), while adjuvant chemotherapy (HR 0.33-0.41), age≥58 years (HR 1.80-1.91), stage III/IV (HR 3.36-13.34), and adnexal metastasis (HR 2.06-5.02) in three to four of the six models for OS. Stratified analyses revealed that adjuvant chemoradiation significantly improved outcome compared with adjuvant chemotherapy for stage IA patients with lymphovascular space invasion and stage IB-IV, lymph node metastasis, and adnexal metastasis.
CONCLUSION
Adjuvant chemoradiation was confirmed as an independent good prognostic factor, while older age, stage III/IV, and adnexal metastasis were associated with poor outcome in UCS.
Topics: Aged; Carcinosarcoma; Chemotherapy, Adjuvant; Combined Modality Therapy; Female; Humans; Hysterectomy; Middle Aged; Neoplasm Staging; Prognosis; Radiotherapy, Adjuvant; Retrospective Studies; Uterine Neoplasms
PubMed: 33992491
DOI: 10.1016/j.jfma.2021.04.016 -
Frontiers in Public Health 2022Carcinosarcoma is a rare biphasic tumor composed of both carcinoma and sarcoma elements, which occurs at various sites. Most studies are case reports or small...
BACKGROUND
Carcinosarcoma is a rare biphasic tumor composed of both carcinoma and sarcoma elements, which occurs at various sites. Most studies are case reports or small population-based studies for a single disease site, so comprehensive evaluations of epidemiology and prognostic factors for carcinosarcoma are needed.
METHODS
Surveillance, Epidemiology, and End Results (SEER)-8 (1975-2019) provided data for the epidemiological analysis. SEER-17 (2000-2019) provided data on the primary tumor sites, initial treatment, construction, and validation of the nomogram.
RESULTS
The age-adjusted incidence per 100,000 persons of carcinosarcoma increased significantly from 0.46 to 0.91 [1975-2019; average annual percent change (AAPC): 1.3%, = 0.006], with localized stage increasing from 0.14 to 0.26 [2005-2015; annual percent change (APC): 4.2%]. The 20-year limited-duration prevalence per 100,000 increased from 0.47 to 3.36 (1999-2018). The mortality per 100,000 increased significantly from 0.16 to 0.51 (1975-2019; AAPC: 1.9%, < 0.001). The 5-year relative survival was 32.8%. The greatest number of carcinosarcomas were from the uterus (68.7%), ovary (17.8%), lung and bronchus (2.3%). The main treatment is comprehensive treatment based on surgery; however, surgery alone is preferred in older patients. In multivariate analysis ( = 11,424), age, sex, race, year of diagnosis, disease stage, tumor site, and treatment were associated with survival. A nomogram was established to predict 1-, 3-, and 5-year survival, and the C-indexes were 0.732 and 0.748 for the training and testing sets, respectively. The receiver operating characteristic curve demonstrated that the nomogram provided a comprehensive and accurate prediction [1-year area under the curve (AUC): 0.782 vs. 0.796; 3-year AUC: 0.771 vs. 0.798; 5-year AUC: 0.777 vs. 0.810].
CONCLUSIONS
In this study, the incidence, prevalence, and mortality of carcinosarcoma have increased over the past decades. There was a rapid rise in the incidence of localized stage in recent years, which reflected improved early detection. The prognosis of carcinosarcoma remains poor, signifying the urgency of exploring targeted cancer control treatments. Explicating distribution and gender disparities of carcinosarcoma may facilitate disease screening and medical surveillance. The nomogram demonstrated good predictive capacity and facilitated clinical decision-making.
Topics: Female; United States; Humans; Aged; Patients; Carcinosarcoma; Nomograms; ROC Curve; Multivariate Analysis
PubMed: 36518582
DOI: 10.3389/fpubh.2022.1038211 -
Journal of the College of Physicians... May 2012A 20 years old Afghan male was suffering from left sided nasal obstruction with headache for one year. On examination, patient had reddish, fleshy mass in left nasal... (Review)
Review
A 20 years old Afghan male was suffering from left sided nasal obstruction with headache for one year. On examination, patient had reddish, fleshy mass in left nasal cavity. Carotid angiography was inconclusive so incision biopsy was taken from nasal mass and it was reported as teratocarcinosarcoma. CT scan of PNS was done which showed heterogeneous mass in nasal cavity, paranasal sinuses with intracranial extension. The patient was operated. The approach was a combination of lateral rhinotomy with trans-basal sub-frontal craniotomy. He was treated by Co 60 and received a tumour dose of 56 Gy radiation. He is being followed regularly every 2 months after his final radiotherapy session and he is disease-free so far.
Topics: Biopsy, Needle; Carcinosarcoma; Chemotherapy, Adjuvant; Craniotomy; Follow-Up Studies; Headache; Humans; Immunohistochemistry; Male; Nasal Obstruction; Nasal Surgical Procedures; Neoplasm Invasiveness; Neoplasm Staging; Nose Neoplasms; Pakistan; Paranasal Sinus Neoplasms; Radiotherapy, Adjuvant; Teratoma; Tomography, X-Ray Computed; Treatment Outcome; Young Adult
PubMed: 22538045
DOI: No ID Found -
Kulak Burun Bogaz Ihtisas Dergisi : KBB... 2014Sinonasal teratocarcinosarcoma is an extremely rare malignant neoplasm presenting with the characteristics of a malignant teratoma and carcinosarcoma. The most common...
Sinonasal teratocarcinosarcoma is an extremely rare malignant neoplasm presenting with the characteristics of a malignant teratoma and carcinosarcoma. The most common sites of origin of teratocarcinosarcomas are the nasal cavity and paranasal sinuses. The clinical presentation is usually with nasal obstruction and episodes of epistaxis. Teratocarcinosarcomas are aggressive and rapidly growing tumors with a poor prognosis. The incidence of sinonasal teratocarcinomas is higher in men than women. Treatment is primarily surgery, followed by radiotherapy. In this article, we report a 46-year-old male case of sinonasal teratocarcinosarcoma who was admitted with complaints of pain and swelling around the right eye and treated surgically followed by radiotherapy.
Topics: Carcinosarcoma; Combined Modality Therapy; Diagnosis, Differential; Humans; Male; Middle Aged; Nasal Obstruction; Nose Neoplasms; Paranasal Sinus Neoplasms; Radiotherapy, Adjuvant; Teratoma
PubMed: 25046074
DOI: 10.5606/kbbihtisas.2014.50490 -
International Journal of Molecular... May 2023Uterine serous carcinoma (USC) and carcinosarcomas (CSs) are rare, highly aggressive variants of endometrial cancer. No reliable tumor biomarkers are currently available...
Uterine serous carcinoma (USC) and carcinosarcomas (CSs) are rare, highly aggressive variants of endometrial cancer. No reliable tumor biomarkers are currently available to guide response to treatment or detection of early recurrence in USC/CS patients. Circulating tumor DNA (ctDNA) identified using ultrasensitive technology such as droplet digital polymerase chain reaction (ddPCR) may represent a novel platform for the identification of occult disease. We explored the use of personalized ctDNA markers for monitoring USC and CS patients. Tumor and plasma samples from USC/CS patients were collected at the time of surgery and/or during the treatment course for assessment of tumor-specific somatic structural variants (SSVs) by a clinical-grade next-generation sequencing (NGS) platform (i.e., Foundation Medicine) and a droplet digital PCR instrument (Raindance, ddPCR). The level of ctDNA was quantified by droplet digital PCR in plasma samples and correlated to clinical findings, including CA-125 serum and/or computed tomography (CT) scanning results. The genomic-profiling-based assay identified mutated "driver" target genes for ctDNA analysis in all USC/CS patients. In multiple patients, longitudinal ctDNA testing was able to detect the presence of cancer cells before the recurrent tumor was clinically detectable by either CA-125 or CT scanning. Persistent undetectable levels of ctDNA following initial treatment were associated with prolonged progression-free and overall survival. In a USC patient, CA-125 and TP53 mutations but not PIK3CA mutations become undetectable in the plasma at the time of recurrence, suggesting that more than one customized probe should be used for monitoring ctDNA. Longitudinal ctDNA testing using tumor-informed assays may identify the presence of residual tumors, predict responses to treatment, and identify early recurrences in USC/CS patients. Recognition of disease persistence and/or recurrence through ctDNA surveillance may allow earlier treatment of recurrent disease and has the potential to change clinical practice in the management of USC and CS patients. CtDNA validation studies in USC/CS patients prospectively enrolled in treatment trials are warranted.
Topics: Female; Humans; Circulating Tumor DNA; Neoplasm Recurrence, Local; Uterine Neoplasms; Biomarkers, Tumor; Mutation; Cystadenocarcinoma, Serous; Carcinosarcoma
PubMed: 37240216
DOI: 10.3390/ijms24108873