Comparing paclitaxel-platinum with ifosfamide-platinum as the front-line chemotherapy for patients with advanced-stage uterine carcinosarcoma

Sep 29, 2026

Uterine carcinosarcoma (UCS) is rare yet highly lethal, and adjuvant chemotherapy is recommended for advanced cases. Standard first-line regimens remain uncertain, with paclitaxel-platinum (PP) and ifosfamide-platinum (IP) commonly used. This retrospective single-institute study compared outcomes after primary cytoreductive surgery. Sixteen advanced UCS patients were analyzed, recording clinical-pathological parameters, recurrence, and survival.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Introduction

Methods

Results

Conclusion

J Chin MedAssoc Original article Comparing paclitaxel-platinum with ifosfamideplatinum as the front-line chemotherapy for patients with advanced-stage uterine carcinosarcoma Ming-Hsuan Sua,b, Hua-Hsi Wua,b, Hsin-Yi Huangc, Na-Rong Leea,d, Wen-Hsun Changa,d, Shih-Chieh Linb,d, Yi-Jen Chena,b, Peng-Hui Wanga,b,e,f,* aDepartment of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; bInstitute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC; cBiostatics Task Force, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; eDepartment of Pathology and Laboratory Medicine, Taipei, Taiwan, ROC; dDepartment of Nursing, Taipei Veterans General Hospital, Taiwan, ROC; fFemale Cancer Foundation, Taipei, Taiwan, ROC; gDepartment of Medical Research, China Medical University Hospital, Taichung, Taiwan, ROC Abstract Background: Uterine carcinosarcoma (UCS) is a rare but highly lethal disease. Adjuvant chemotherapy is highly recommended for advanced UCS. To date, the standard chemotherapy regimen is still uncertain, although two regimens as paclitaxel-platinum (PP) and ifosfamide-platinum (IP) regimens are most commonly used. The aims of the current study attempt to compare both regimens in the management of advanced UCS patients. Methods: We evaluated advanced UCS patients who were treated either with PP or with IP after primary cytoreductive surgery in single institute retrospectively. The clinical-pathological parameters, recurrence, and survival were recorded. Results: A total of 16 patients were analyzed. Twelve patients received adjuvant PP therapy, and the remaining four patients received IP therapy. The median follow-up time was 28 months, ranging from 3.8 months to 121 months. Disease-related death occurred in 10 patients (62 .5%) . The median progression-free survival was 4.9 months, ranging from 3.8 months to 36.5 months in IP, and 23.1 months, ranging from 9.3 months to 121 months in PP, with statistically significant difference (p = 0 .04) . The median overall survival was 9.5 months (ranging from 3.8 months to 36.5 months) and 28.7 months (ranging from 10.3 months to 121 months) in IP and PP, respectively, without statistically significant difference (p = 0 .06) . Presence of pelvic and para-aortic lymphadenopathy and deep myometrial invasion (>1/2) were associated with worse prognosis by univariate analysis. No prognostic factor could be identified using multivariate analysis model. Conclusion: In the current study, due to extremely little number of subjects enrolled, the advantage of using paclitaxel-platinum regimen in the management of advanced UCS was still unclear, although a certain trend of favoring was supposed. We are looking forward to seeing more studies to identify the approximate regimen in the management of this highly lethal disease. Keywords: Adjuvant therapy; Carcinosarcoma; Chemotherapy; Outcome; Uterine; Uterus 1. INTRODUCTION Malignant mixed Müllerian tumors (MMMT, carcinosarcomas [CS]) of female genital tract are defined histologically as a biphasic tumor consisting of both carcinoma (malignant epithelial elements) and sarcoma (malignant mesenchymal or stromal *Address Correspondence. Dr. Peng-Hui Wang, Department of Obstetricsand Gynecology, Taipei Veterans General Hospital, 201, Section 2, Shi-Pai Road, Taipei 112, Taiwan, [ROC. E-mail addresses: phwang@vghtpe.gov.tw](ROC. E-mail addresses: phwang@vghtpe.gov.tw); [pongpongwang@gmail.com](pongpongwang@gmail.com) (P.-H. Wang). Conflicts of interest: Dr. Peng-Hui Wang, an editorial board member at Journal of the Chinese Medical Association, had no role in the peer review process or decision to publish this article. The other authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article. Journal of Chinese Medical Association. (2022) 85: 204-211. Received June 18, 2021; accepted July 22, 2021. doi: 10

FAQs

What is the main purpose of the study comparing PP and IP regimens?

To compare paclitaxel-platinum (PP) and ifosfamide-platinum (IP) as front-line chemotherapy for patients with advanced-stage uterine carcinosarcoma.

How were the patients treated and how were outcomes measured?

Advanced UCS patients received either PP or IP after primary cytoreductive surgery. Clinical-pathological parameters, recurrence, and survival were recorded.

What did the study find regarding progression-free and overall survival?

Median progression-free survival differed significantly between IP and PP (p=0.04), while median overall survival showed no statistically significant difference (p=0.06).

Did the study identify prognostic factors for outcomes?

Univariate analysis associated pelvic/para-aortic lymphadenopathy and deep myometrial invasion (>1/2) with worse prognosis, while multivariate analysis found no prognostic factors.

Sep 29, 2026

Upload by Maya Linwood