What is the prognosis of true malignant mixed tumor (carcinosarcoma)?

Updated: Dec 01, 2015
  • Author: M Sherif Said, MD, PhD; Chief Editor: M Sherif Said, MD, PhD  more...
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Carcinosarcoma is an aggressive, high-grade tumor. Recurrence, distant metastasis (54%), and angiolymphatic invasion are frequently encountered. The lungs are the most common site of metastasis. Metastasis may also occur to the liver, bones, and brain. Involvement of cervical lymph nodes with metastasis is uncommon.

In a review by Gnepp, [3] 58% of patients died as a result of the tumor. A review of 19 cases of de novo carcinosarcomas by Staffeieri et al [16] found that 31.6% of patients died of the disease. The median period of survival after diagnosis was 10 months; in 63% of cases, there was no evidence of recurrence after a median period of 22.4 months.

Because of the rarity of the tumor, whether arising de novo or in a pleomorphic adenoma, consensus on therapeutic approaches has been lacking. A combination of surgery followed by radiotherapy seems to be statistically superior to resection alone. [16, 29] The role of chemotherapy remains unclear.

The results of a retrospective analysis of 15 cases of sinonasal carcinosarcoma suggested that patients with sinonasal carcinosarcoma have disease-specific survival comparable to the case-matched cohort of salivary gland carcinosarcoma patients. The study added that sinonasal carcinosarcoma patients have significantly poor survival outcomes compared to patients from the cohort of carcinosarcoma at all other head and neck sites. [30]

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