Malignant Mixed Mullerian Tumour (MMMT) also known as carcinosarcoma is a rare and aggressive malignancy involving the uterine corpus. Despite aggressive treatment, they have a poor outcome. We performed this study to analyze the clinical profile, prognostic features, and treatment outcome of patients with MMMT of uterine corpus treated in our center.
The study sample was drawn from a database of patients treated at the Department of Medical Oncology, Madras Medical College between January 2015 and December 2019. A total of 29 non-metastatic patients were included in the study. Information regarding the patient, tumour characteristics, details of the surgery, adjuvant therapy, and the follow-up details were collected retrospectively. Disease-free survival and overall survival were plotted using the Kaplan-Meier method and the log-rank test was used to identify any significant prognostic factor. Statistical analyses were performed using SPSS software version 21.
The median age of the population was 60 years (IQR- 52- 65). The homologous type was the most common pathology seen in 21 patients. The median size of the tumor was 7 cm. (IQR- 6 – 10). The median DFS was 12 months (95% C.I 7.7 – 16.2). Paclitaxel and carboplatin-based adjuvant chemotherapy were used in 60 % of the patients. During the follow-up, 17 patients developed recurrence and almost 90% were distant recurrences. The median DFS was 12 months (95% C.I 7.7 – 16.2). The median Overall Survival was 26 months (95% C.I 10.6 – 41.3). The 3-year overall survival rate was 42 %. Patients with age >60 years had a median overall survival of 11 months vs 37 months for patients <60 years (p=0.026). The median overall survival of patients with tumour size >10 cm was 12.5 months and 35 months for tumour size <10 cm (p=0.03). Patients receiving RT had an improved survival (39 months) than those who did not receive RT (12.5 months) P=0.046. The median overall survival for patients after the recurrence was 12 months. As most patients were elderly and had a poor performance status during the relapse, only a few patients were fit for subsequent lines of chemotherapy.
MMMT is an aggressive tumor with poor survival rates. Age of the patient, tumor size, and radiation therapy were found to be prognostic factors.
The authors.
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All authors have declared no conflicts of interest.