Clinical characteristics and survival outcomes in uterine carcinosarcoma: A population-based analysis.

Abstract

e17647 Background: Uterine carcinosarcoma (UCS), a rare and aggressive malignancy, representing less than 5% of uterine cancers but accounts for 16% of uterine cancer-related deaths. This study investigates the clinical characteristics, management, and outcomes of UCS patients. Methods: Data on uterine carcinosarcoma cases diagnosed between 2000 and 2021 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Survival outcomes were assessed through Kaplan-Meier survival analysis, and the statistical significance of key variables was determined using the log-rank test. Cox proportional hazards modeling was employed to calculate hazard ratios (HR). Results: From 2000 to 2021, 16,273 patients were diagnosed with uterine carcinosarcoma. The majority of patients were aged 60–79 years (66%) and predominantly identified as white race (67%). Most patients (88%) identified as Non-Hispanic/Latino. Socioeconomic analysis showed that 52% of patients had a household income between $60,000 and $84,999, with 68% earning less than $85,000 annually. Geographically, 69% lived in metropolitan counties with populations exceeding 1 million. Grade 3 tumors and undifferentiated tumor made up the majority of cases (63% and 30%). Regarding treatment, 78% of patients underwent surgery, 56% received chemotherapy, and 36% had radiation therapy. The 5 year and overall survival rates were 39% and 26%. Factors significantly influencing survival included race, metastasis at diagnosis, median household income, and treatment modalities. Patients who received surgery, radiation, or chemotherapy demonstrated significantly improved survival compared to those who did not undergo these treatments. Conclusions: Survival outcomes in UCS patients is overall very poor but varies widely and may be influenced by clinical and demographic factors. Continued research is crucial to optimize therapeutic strategies for this rare and aggressive type of uterine cancer.