An adjuvant combination paclitaxel and carboplatin chemotherapy in uterine carcinosarcomas: two case reports and a review literature of adjuvant chemotherapy

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  • SATAKE Yumiko
    Department of Obstetrics and Gynecology, Otsu Municipal Hospital
  • KAN Hyun sook
    Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine
  • MOGAMI Haruta
    Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine
  • TAKAHASHI Akimasa
    Department of Obstetrics and Gynecology, Otsu Municipal Hospital
  • UDA Satoko
    Department of Obstetrics and Gynecology, Otsu Municipal Hospital
  • YOKOTA Hiromi
    Department of Obstetrics and Gynecology, Otsu Municipal Hospital
  • URASAKI Koji
    Department of Pathology, Otsu Municipal Hospital
  • HAMADA Shinshichi
    Department of Pathology, Otsu Municipal Hospital
  • TAKAHASHI Yoshiki
    Department of Obstetrics and Gynecology, Otsu Municipal Hospital

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Other Title
  • 子宮体部癌肉腫におけるパクリタキセル・カルボプラチン療法
  • 症例報告 子宮体部癌肉腫におけるパクリタキセル・カルボプラチン療法--2症例の臨床経過と術後補助化学療法に関する考察(review literature)
  • ショウレイ ホウコク シキュウタイブガン ニクシュ ニ オケル パクリタキセル カルボプラチン リョウホウ 2 ショウレイ ノ リンショウ ケイカ ト ジュツゴ ホジョ カガク リョウホウ ニ カンスル コウサツ review literature
  • ―2症例の臨床経過と術後補助化学療法に関する考察（review literature）―

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Abstract

A carcinosarcoma is a rare tumor of the uterus with a poor prognosis. The purpose of the present study was to evaluate clinical findings from 2 cases of uterine carcinosarcomas and a review literature of adjuvant chemotherapy. In two cases, histological findings showed the uterine carcinosarcoma according a preoperative endometrial curettage. Two patients underwent modified radical hysterectomy procedures, including bilateral salpingo-oophorectomy, pelvic/para-aortic lymphadenectomy, and an intraperitoneal carboplatin (450mg) therapy. In addition, adjuvant therapy consisting combination TC chemotherapy (pacritaxel 175mg/m2, carboplatin AUC : 6) was administered to both patients. In the 52-year old woman, the tumor with pT3aN0M0 disease was homologous carcinosarcoma with a G1 endometrioid adenocarcinomas and a sarcoma component (leiomyosarcoma) was also noted. In the second patients (54 year-old), the tumor with pT1bN0M0 disease was heterologous carcinosarcoma with a G2 endometrioid adenocarcinomas and had sarcoma components (osteosarcoma and chondrosarcoma). The first patients was classified as stage IIIa, with ovarian metastasis and rectal peritoneal dissemination, and died 9 months after the operation with a recurrent pelvic tumor. The second patient was classified as stage Ib and demonstrated disease-free survival for up to 3.5 years after the surgery. In 2 patients, no residual tumor was found after the surgery. For cases of early stage uterine carcinosarcoma, the surgery and adjuvant TC chemotherapy may be effective, whereas, it was not effective therapy for the present stage IIIa case. TC chemotherapy may have been the standard adjuvant chemotherapy for uterine carcinosarcomas. However, the development of effective second-line chemotherapy is an important issue for the TC chemotherapy-resistant uterine carcinosarcomas. [Adv Obstet Gynecol, 63(1) : 11-17, 2011 (H23.2)]

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