Book contents
- 50 Big Debates in Gynecologic Oncology
- 50 Big Debates in Gynecologic Oncology
- Copyright page
- Contents
- Contributors
- Section I Perioperative Management
- Section II Screening, Prevention, and Early Diagnosis
- Section III Ovarian Cancer
- Section IV Endometrial Cancer
- Debate 28A Fertility-sparing Surgery in Early-stage Endometrial Cancer is Safe and Does not Compromise Oncological Outcome
- Debate 28B Fertility-sparing Treatment for Early-stage Endometrial Cancer is Safe and Does Not Compromise Oncological Outcome
- Debate 29A Sentinel Lymph Node Mapping Should be the Standard for Staging Patients with High-grade Endometrial Cancers
- Debate 29B Sentinel Lymph Node Mapping Should be the Standard for Staging Patients with High-grade Endometrial Cancers
- Debate 30A Molecular Profiling Should be Done to Guide the Management of Endometrial Cancer?
- Debate 30B Molecular Profiling Should be Done to Guide the Management of Endometrial Cancer?
- Debate 31A What is the Best Adjuvant Therapy for Management of Stage III Endometrial Cancer?
- Debate 31B What is the Best Adjuvant Therapy for Management of Stage III Endometrial Cancer?
- Debate 32A How Should Stage IA Serous Papillary Endometrial Cancer Confined to a Polyp or the Endometrial Lining be Managed?
- Debate 32B How Should Stage IA Serous Papillary Endometrial Cancer Confined to a Polyp or the Endometrial Lining be Managed?
- Debate 33A What is the Optimal Sequence of Therapy for Patients with Stage IIIC Endometrial Carcinoma Treated with Multimodal Therapy?
- Debate 33B What is the Optimal Sequence of Therapy for Patients with Stage IIIC Endometrial Carcinoma Treated with Multimodal Therapy?
- Debate 34A Should an Attempt at Debulking Grossly Metastatic Endometrial Cancer be Undertaken?
- Debate 34B Should an Attempt at Debulking Grossly Metastatic Endometrial Cancer be Undertaken?
- Debate 35A Should Secondary Cytoreduction be Performed for Recurrent Endometrial Cancer?
- Debate 35B Should Secondary Cytoreduction be Performed for Recurrent Endometrial Cancer?
- Debate 36A Is Hormonal Therapy the Best Therapy for Chemo-resistant Endometrial Cancer?
- Debate 36B Is Hormonal Therapy the Best Therapy for Chemo-resistant Endometrial Cancer?
- Debate 37A Is there a Role for Using Immunotherapy in Endometrial Cancer?
- Debate 37B Is there a Role for Using Immunotherapy in Endometrial Cancer?
- Debate 38A What is the Best Chemotherapy Regimen for Uterine Carcinosarcoma?
- Debate 38B What is the Best Chemotherapy Regimen for Uterine Carcinosarcoma?
- Debate 39A What is the Best Management for Premenopausal Women with Early-stage Uterine Leiomyosarcoma Status Post Hysterectomy for Presumed Uterine Leiomyomas?
- Debate 39B What is the Best Management for Premenopausal Women with Early-stage Uterine Leiomyosarcoma Status Post Hysterectomy for Presumed Uterine Leiomyomas?
- Debate 40A Should Primary Debulking Surgery be Performed for Metastatic Leiomyosarcoma?
- Debate 40B Should Primary Debulking Surgery be Performed for Metastatic Leiomyosarcoma?
- Debate 41A Should Secondary Cytoreductive Surgery be Offered to all Patients that are Surgical Candidates with Optimally Resectable Recurrent Uterine Leiomyosarcoma?
- Debate 41B Should Secondary Cytoreductive Surgery be Offered to all Patients that are Surgical Candidates with Optimally Resectable Recurrent Uterine Leiomyosarcoma?
- Section V Cervical Cancer
- Section VI Vaginal and Vulvar Cancer
- Index
- References
Debate 38B - What is the Best Chemotherapy Regimen for Uterine Carcinosarcoma?
The Case for “Other” Regimens
from Section IV - Endometrial Cancer
Published online by Cambridge University Press: 20 July 2023
Book contents
- 50 Big Debates in Gynecologic Oncology
- 50 Big Debates in Gynecologic Oncology
- Copyright page
- Contents
- Contributors
- Section I Perioperative Management
- Section II Screening, Prevention, and Early Diagnosis
- Section III Ovarian Cancer
- Section IV Endometrial Cancer
- Debate 28A Fertility-sparing Surgery in Early-stage Endometrial Cancer is Safe and Does not Compromise Oncological Outcome
- Debate 28B Fertility-sparing Treatment for Early-stage Endometrial Cancer is Safe and Does Not Compromise Oncological Outcome
- Debate 29A Sentinel Lymph Node Mapping Should be the Standard for Staging Patients with High-grade Endometrial Cancers
- Debate 29B Sentinel Lymph Node Mapping Should be the Standard for Staging Patients with High-grade Endometrial Cancers
- Debate 30A Molecular Profiling Should be Done to Guide the Management of Endometrial Cancer?
- Debate 30B Molecular Profiling Should be Done to Guide the Management of Endometrial Cancer?
- Debate 31A What is the Best Adjuvant Therapy for Management of Stage III Endometrial Cancer?
- Debate 31B What is the Best Adjuvant Therapy for Management of Stage III Endometrial Cancer?
- Debate 32A How Should Stage IA Serous Papillary Endometrial Cancer Confined to a Polyp or the Endometrial Lining be Managed?
- Debate 32B How Should Stage IA Serous Papillary Endometrial Cancer Confined to a Polyp or the Endometrial Lining be Managed?
- Debate 33A What is the Optimal Sequence of Therapy for Patients with Stage IIIC Endometrial Carcinoma Treated with Multimodal Therapy?
- Debate 33B What is the Optimal Sequence of Therapy for Patients with Stage IIIC Endometrial Carcinoma Treated with Multimodal Therapy?
- Debate 34A Should an Attempt at Debulking Grossly Metastatic Endometrial Cancer be Undertaken?
- Debate 34B Should an Attempt at Debulking Grossly Metastatic Endometrial Cancer be Undertaken?
- Debate 35A Should Secondary Cytoreduction be Performed for Recurrent Endometrial Cancer?
- Debate 35B Should Secondary Cytoreduction be Performed for Recurrent Endometrial Cancer?
- Debate 36A Is Hormonal Therapy the Best Therapy for Chemo-resistant Endometrial Cancer?
- Debate 36B Is Hormonal Therapy the Best Therapy for Chemo-resistant Endometrial Cancer?
- Debate 37A Is there a Role for Using Immunotherapy in Endometrial Cancer?
- Debate 37B Is there a Role for Using Immunotherapy in Endometrial Cancer?
- Debate 38A What is the Best Chemotherapy Regimen for Uterine Carcinosarcoma?
- Debate 38B What is the Best Chemotherapy Regimen for Uterine Carcinosarcoma?
- Debate 39A What is the Best Management for Premenopausal Women with Early-stage Uterine Leiomyosarcoma Status Post Hysterectomy for Presumed Uterine Leiomyomas?
- Debate 39B What is the Best Management for Premenopausal Women with Early-stage Uterine Leiomyosarcoma Status Post Hysterectomy for Presumed Uterine Leiomyomas?
- Debate 40A Should Primary Debulking Surgery be Performed for Metastatic Leiomyosarcoma?
- Debate 40B Should Primary Debulking Surgery be Performed for Metastatic Leiomyosarcoma?
- Debate 41A Should Secondary Cytoreductive Surgery be Offered to all Patients that are Surgical Candidates with Optimally Resectable Recurrent Uterine Leiomyosarcoma?
- Debate 41B Should Secondary Cytoreductive Surgery be Offered to all Patients that are Surgical Candidates with Optimally Resectable Recurrent Uterine Leiomyosarcoma?
- Section V Cervical Cancer
- Section VI Vaginal and Vulvar Cancer
- Index
- References
Summary
Uterine carcinosarcoma (UCS) are rare tumors with high aggressive behavior. Chemotherapy is the mainstay of treatment either in the adjuvant and the metastatic setting. Previous carcinogenetic theory considered carcinosarcoma as a biphasic tumor with an epithelial and mesenchymal component and were treated accordingly with drugs directed towards these two components (i.e. cisplatin-ifosfamide). Actually UCS are reclassified as epithelial cancers with metaplastic de-differentiated components and drugs with proven activity in epithelial tumors (i.e. carboplatin-paclitaxel) have been implemented in the treatment algorithm. The paper will review literature evidences in UCS treatment and will support the strategy which identify carboplatin-paclitaxel as the standard of care.
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- Information
- 50 Big Debates in Gynecologic Oncology , pp. 232 - 233Publisher: Cambridge University PressPrint publication year: 2023
References
Powell, MA, et al. A randomized phase 3 trial of paclitaxel (P) plus carboplatin (C) versus paclitaxel plus ifosfamide (I) in chemotherapy-naive patients with s-IV, persistent or recurrent carcinosarcoma of the uterus or ovary: an NRG Oncology trial. J Clin Oncol 2022;40(9):968–977.CrossRefGoogle ScholarPubMed
Berton-Rigaud, D, et al. Gynecologic Cancer InterGroup (GCIG) consensus review for uterine and ovarian carcinosarcoma. Int J Gynecol Cancer 2014;24(9 Suppl. 3): S55–60.CrossRefGoogle ScholarPubMed
Cherniack, AD, et al. Integrated molecular characterization of uterine carcinosarcoma. Cancer Cell 2017;31(3):411–423. https://doi.org/10.1016/j.ccell.2017.02.010CrossRefGoogle ScholarPubMed
Zhao, S, et al. Mutational landscape of uterine and ovarian carcinosarcomas implicates histone genes in epithelial-mesenchymal transition. Proc Natl Acad Sci U S A 2016;113(43):12238–12243. https://doi.org/10.1073/pnas.1614120113CrossRefGoogle ScholarPubMed