Background/Objectives: Uterine carcinosarcoma (UCS) refers to a rare high-grade aggressive epithelial non-endometrioid endometrial carcinoma, with tumour cells demonstrating epithelial–mesenchymal metaplastic transition and composed of both carcinomatous epithelial and sarcomatous (homologous or heterologous) components. Methods: The aim of this study was to evaluate the epidemiology, management approach, outcomes and survival patterns of patients with UCS. Seventy-seven cases of UCS treated with primary surgery in a single tertiary centre underwent retrospective cohort analysis across a ten-year period. Observational data on clinicopathological variables and treatment pathways were reviewed and independent risk factors for relapse and mortality were analysed. Results: The 5-year disease-free and overall survival rates were 52.10% and 46.6%, respectively. Cervical stromal involvement was independently related to disease-free survival (HR = 6.26; 95%CI 1.82–21.59;p= 0.004) and overall survival (HR = 3.64; 95%CI 1.42–9.38;p= 0.007), whilst sarcomatous component type was independently related to recurrence only (HR = 3.62; 95%CI 1.38–9.51;p= 0.009) after adjusting for other pathological and treatment variables. No significant difference in recurrence or mortality was found when comparing the performance of pelvic lymph node dissection (p= 0.803 andp= 0.192 respectively) or the administration of adjuvant treatment (p= 0.546 andp= 0.627 respectively). Conclusions: Whilst our data suggests an encouraging similarity in overall survival rates compared with the literature, UCS continues to represent significant treatment challenges—with a paucity of guidelines available. Data regarding molecular analysis was not systemically available in our cohort, the more recent introduction of which (alongside the revision of endometrial cancer staging) will undoubtedly provide UCS patients with improved therapeutic options in the future.
背景/目的：子宫癌肉瘤是一种罕见的高级别侵袭性上皮性非子宫内膜样子宫内膜癌，其肿瘤细胞呈现上皮-间质化生转变，并由癌性上皮成分和肉瘤性（同源或异源）成分共同构成。方法：本研究旨在评估子宫癌肉瘤患者的流行病学特征、治疗策略、临床结局及生存模式。通过对单一三级医疗中心十年间接受初次手术治疗的77例子宫癌肉瘤病例进行回顾性队列分析，系统评估了临床病理学变量与治疗路径的观察数据，并分析了复发与死亡的独立危险因素。结果：五年无病生存率和总生存率分别为52.10%和46.6%。在调整其他病理及治疗变量后，宫颈间质浸润与无病生存期（HR=6.26；95%CI 1.82-21.59；p=0.004）及总生存期（HR=3.64；95%CI 1.42-9.38；p=0.007）独立相关，而肉瘤成分类型仅与复发风险独立相关（HR=3.62；95%CI 1.38-9.51；p=0.009）。盆腔淋巴结清扫术的实施（p值分别为0.803和0.192）及辅助治疗的开展（p值分别为0.546和0.627）在复发率或死亡率方面均未呈现显著差异。结论：尽管本数据显示总生存率与文献报道具有令人鼓舞的一致性，子宫癌肉瘤仍因缺乏权威指南而面临重大治疗挑战。本研究队列中未能系统获取分子分析数据，而该技术的最新应用（结合子宫内膜癌分期的修订）必将为子宫癌肉瘤患者提供更优化的未来治疗选择。
肿瘤(癌症)患者之家