Original Article Effect of Adjuvant Therapy on Oncologic Outcomes of Surgically Approved Stage I Uterine Carcinosarcoma: Turkish Gynecologic Oncology Study Kimyon Cömert et al. Stage I Uterine Carcinosarcoma Günsu Kimyon Cömert 1 , Osman Türkmen 1 , Gökhan Boyraz 2 , İbrahim Yalçın 3 , Duygu Altın 4 , Alper Karalök 1 , Hanifi Şahin 3 , Salih Taşkın 4 , Derman Başaran 1 , Zeliha Fırat Cuylan 3 , Kazibe Koyuncu 4 , Mehmet Coşkun Salman 2 , Nejat Özgül 2 , Mehmet Mutlu Meydanlı 3 , Taner Turan 1 , Fırat Ortaç 4 , Kunter Yüce 2 1 Department of Gynecologic Oncology, Ankara Etlik Zübeyde Hanım Women’s Diseases Training and Research Hospital, Ankara, Turkey 2 Department of Gynecologic Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey 3 Department of Gynecologic Oncology, University of Health Sciences, Ankara Zekai Tahir Burak Women’s Health Training and Research Hospital, Ankara, Turkey 4 Department of Gynecologic Oncology, Ankara University School of Medicine, Ankara, Turkey. Address for Correspondence: Günsu Kimyon Cömert, Department of Gynecologic Oncology, Ankara Etlik Zübeyde Hanım Women’s Diseases Training and Research Hospital, Ankara, Turkey Phone: +90 312 322 01 80 e-mail: gunsukimyon@gmail.com Received: 22 December 2018 Accepted: 8 March 2019 DOI: 10.4274/balkanmedj.galenos.2019.2018.12.75 Cite this article as: Kimyon Cömert G, Türkmen O, Boyraz G, Yalçın İ, Altın D, Karalök A, et al. Effect of Adjuvant Therapy on Oncologic Outcomes of Surgically Approved Stage I Uterine Carcinosarcoma: Turkish Gynecologic Oncology Study. Balkan Med J Background: Uterine carcinosarcoma (UCS) is rare neoplasm that mostly presents as metastatic disease. Stage is one of the most important prognostic factor, however, the management of the early stage UCS is still controversial. Aims: To evaluate prognostic factors, treatment options, and survival outcomes in patients with surgically approved stage I UCS. Study Design: Cross-sectional study Methods: Data of 278 patients with UCS obtained from four gynecologic oncology centers were reviewed, and 70 patients with approved stage I UCS after comprehensive staging surgery were studied. Results: The median age of the entire cohort was 65 years (range; 39–82). All patients underwent both pelvic and paraaortic lymphadenectomy. Forty-one patients received adjuvant therapy. The median follow-up time was 24 months (range; 1–129). Nineteen (27.1%) patients had disease failure. The 3-year disease-free survival (DFS) and cancer-specific survival (CSS) of the entire cohort was 67% and 86%, respectively. In the univariate analysis, only age was significantly associated with DFS (p=0.022). There was no statistical significance for DFS between observation and receiving any type of adjuvant therapy following staging surgery. Advanced age (<75 vs. ≥75 years) was the only independent prognostic factor for recurrence (hazard ratio: 3.8, 95% CI=1.10– 13.14, p=0.035) in multivariate analysis. None of the factors were significantly associated with CSS. Conclusion: Advanced age was the only independent factor for DFS in stage I UCS. Performing any adjuvant therapy following comprehensive lymphadenectomy was not related to the improved survival of the stage I disease. Keywords: Carcinosarcoma, lymphadenectomy, stage, therapy, uterus Uterine carcinosarcoma (UCS) is a rare uterine neoplasm, with an incidence of 3‒4% among all uterine malignancies [1]. UCS is associated with high risks for metastatic disease at presentation, recurrence, and poor survival [1-3]. Pathologic stage is the most important predictive factor for survival, but the recurrence rate is high, even in the early stages of the disease [2, 4]. The incidence of stage I and II disease is 35–40% [5, 6]. Definitive staging surgery that includes complete lymphadenectomy is recommended as a maintenance treatment for early-stage UCS [1, 6-8]. Furthermore, the survival benefit of lymphadenectomy increases with increasing removed lymph node counts [8]. However, controversial results exist regarding the necessity and the type of Uncorrected Proof