Chemotherapeutic management of recurrent/metastatic uterine carcinosarcomas (malignant mixed mullerian tumors): time for a re-appraisal?

Maurie Markman1

(1) University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, (Mail Box # 121), Houston, Texas 77030, USA
(2) The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, Ohio 44195, USA

Received: 22 March 2004 Accepted: 27 May 2004 Published online: 5 August 2004

Abstract
Purpose Optimal chemotherapeutic management of recurrent/metastatic uterine carcinosarcomas remains undefined. Despite this fact, the selection of a cytotoxic anti-neoplastic drug regimen for an individual patient with this rare malignancy may substantially impact both short-term symptomatic improvement and overall quality-of-life, which includes the toxicity of therapy.
Patients and methods Two women with metastatic uterine carcinosarcomas recently treated at the Cleveland Clinic received therapy (carboplatin/paclitaxel) directly aimed at the adenocarcinoma component of their mixed endometrial cancers.
Results Both patients achieved substantial short-term objective and subjective improvement in cancer-related signs and symptoms, while experiencing limited treatment-associated toxicities.
Conclusion This limited experience, and additional available data, suggest it is rational to initially treat patients with recurrent/metastatic uterine carcinosarcomas with anti-neoplastic drug strategies currently employed in the management of endometrial adenocarcinomas.
Keywords Uterine carcinosarcoma - Carboplatin - Paclitaxel