902P - Ovarian carcinosarcoma management: A retrospective analysis of the Royal Marsden experience

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Ovarian Cancer
Presenter Cristina Migali
Citation Annals of Oncology (2014) 25 (suppl_4): iv305-iv326. 10.1093/annonc/mdu338
Authors C. Migali1, J.P. Lima1, A. George2, C. Della Pepa1, S.B. Kaye1, M.E. Gore1, S. Banerjee1
  • 1Gynaecology Unit, The Royal Marsden NHS Foundation Trust, SM25PT - London/GB
  • 2Gynaecology Unit, Royal Marsden NHS Foundation Trust, SM25PT - London/GB



The optimal management of ovarian carcinosarcoma (OCS) is not established and prospective evidence is limited due to its rarity. The aim was to determine the effectiveness of treatment and explore potential factors predicting clinical outcome.


A retrospective analysis of patients (pts) with OCS consecutively treated at The Royal Marsden Hospital between 2003 and 2012 was performed.


66 pts were identified (mean age 65.3 years (42.4-86), FIGO stage III/IV at diagnosis 83%). 88% (58 pts) underwent surgery (41 primary, 17 interval) and optimal debulking was achieved in 65.5%. 94% (62 pts) received first line chemotherapy (38 adjuvant, 17 neoadjuvant, 7 without surgery). 3 pts had rapid progression resulting in death before chemotherapy. Platinum-based chemotherapy was used in 98% of pts. Radiological best response rate (RR) was 63%, with no significant difference between regimens (carboplatin/pegylated liposomal doxorubicin 67%, carboplatin/paclitaxel 60%, carboplatin 57%). 45 pts (73%) developed relapse/progression after first line chemotherapy (9 (20%) platinum-refractory, 23 (51%) platinum-resistant and 13 (29%) platinum-sensitive). 34 pts received further systemic treatment (radiological RR platinum-sensitive 42%, resistant 27%, refractory 0%). The median total number of systemic treatment lines from diagnosis was 2 (range 0-8). The median time from diagnosis to progression was 11.7 months (95%CI 10.1-13.5) for all patients and only 5.4 months for stage IV. In univariate analysis FIGO stage (p = 0.002), surgery (p < 0.001) and optimal debulking (p = 0.039) were associated with time to progression. Overall survival (OS) was 21 months (95%CI 15-32.7). In univariate analysis FIGO stage (p < 0.001), response to first line chemotherapy, platinum sensitivity at relapse and surgery (p = 0.001) were associated with OS. OS was longer in pts who had optimal debulking (31.6 vs 16.5 months) but this did not reach statistical significance.


OCS is a challenging disease. Clinical outcomes are poor compared to high grade serous carcinoma. Surgery and platinum-based chemotherapy are important management options for OCS. Rare cancers registries and randomised trials including OCS are needed to define optimal therapy.


All authors have declared no conflicts of interest.