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Related Articles

Ascorbic acid inhibits the migration of Walker 256 carcinosarcoma cells.

Cell Mol Biol Lett. 2008;13(1):103-11

Authors: Wybieralska E, Koza M, Sroka J, Czyz J, Madeja Z

The results of several experimental studies have shown that ascorbic acid inhibits tumor growth and metastasis. Ascorbic acid is an antioxidant that acts as a scavenger for a wide range of reactive oxygen species (ROS). Both tumour metastasis and cell migration have been correlated with the intracellular ROS level, so it was postulated that the inhibitory effect of ascorbic acid derivatives on cell motility may be caused by scavenging of ROS. Time-lapse analyses of Walker 256 carcinosarcoma cell migration showed that both the speed of movement and the cell displacement were inhibited by ascorbic acid applied in concentrations ranging from 10 to 250 microM. This effect correlated with a reduction in the intracellular ROS level in WC 256 cells, suggesting that ROS scavenging may be a mechanism responsible for the inhibition of WC 256 cell migration. However, another potent antioxidant, N-acetyl-L-cysteine, also efficiently decreased the intracellular ROS level in WC 256 cells, but did not affect the migration of the investigated cells. These results demonstrate that intact, unmodified ascorbic acid applied in physiologically relevant and non-toxic concentrations exerts an inhibitory effect on the migration of WC 256 carcinosarcoma cells, and that this may be one of the factors responsible for the anti-metastatic activity of vitamin C. However, our data does not support the hypothesis that the scavenging of intracellular ROS is the main mechanism in the inhibition of cancer cell migration by ascorbic acid.

PMID: 17965972 [PubMed - indexed for MEDLINE]

Combination chemotherapy with carboplatin, paclitaxel and pegylated liposomal doxorubicin for advanced or recurrent carcinosarcoma of the uterus: Clinical experience of a single institution.

Gynecol Oncol. 2008 Jul 3;

Authors: Pectasides D, Pectasides E, Papaxoinis G, Xiros N, Sykiotis C, Papachristodoulou A, Tountas N, Panayiotides J, Economopoulos T

OBJECTIVES: The purpose of this study was to evaluate the activity and toxicity of carboplatin, paclitaxel and pegylated liposomal doxorubicin combination in advanced or recurrent of the uterine carcinosarcoma. METHODS: Twenty-nine eligible patients with measurable disease were treated with carboplatin [area under the curve (AUC) 5], paclitaxel 175mg/m(2) and pegylated liposomal doxorubicin 25 mg/m(2) every 3 weeks for 6-8 cycles. RESULTS: There were 10 complete responses (CRs) (34%) and 8 partial responses (PRs) (28%) for an overall response rate (RR) of 62% (95% confidence interval [CI], 43-81%). The median progression-free survival (PFS) was 8.2 months (95% CI, 4.1-12.2 months) and the median overall survival (OS) was 16.4 months (95% CI, 14.7-18.0 months). There was no statistically significant difference between histology and response to therapy. Patients with PS of 0 or 1 had a higher RR than those with worst PS. Toxicity was generally mild except for myelotoxicity. Neutropenia grade 3/4 was recorded in 52% of patients and 10% experienced febrile neutropenia. Anemia grade 3 or 4 developed in 27% of patients and thrombocytopenia grade 3 or 4 in 31% of patients. Three patients (10%) developed grade 3 sensory neuropathy and only 2 patients (8%) grade 3 palmar-plantar erythrodysesthesias. No treatment-related deaths were recorded in our series. CONCLUSION: The combination of carboplatin, paclitaxel and pegylated liposomal doxorubicin appears to have activity in advanced, persistent or recurrent endometrial carcinosarcoma with an acceptable toxicity profile.

PMID: 18602677 [PubMed - as supplied by publisher]

Uterine Carcinosarcomas and Grade 3 Endometrioid Cancers: Evidence for Distinct Tumor Behavior.

Obstet Gynecol. 2008 Jul;112(1):64-70

Authors: Bansal N, Herzog TJ, Seshan VE, Schiff PB, Burke WM, Cohen CJ, Wright JD

OBJECTIVE: To compare the clinical behavior and outcome of uterine carcinosarcomas and grade 3 endometrioid carcinomas. METHODS: Data on patients with grade 3 endometrioid adenocarcinomas and uterine carcinosarcomas, from 1988 to 2004, was obtained from the Surveillance, Epidemiology, and End Results database. Mortality was analyzed using Cox proportional hazards models. Survival analysis was performed with the Kaplan-Meier method and log rank test. RESULTS: The cohort included 8,986 women with 5,024 (56%) grade 3 endometrioid carcinomas and 3,962 (44%) uterine carcinosarcomas. Women with uterine carcinosarcomas were older (aged 70 years compared with 66 years; P<.001) and more often nonwhite (23% compared with 15%; P<.001). These women presented with more advanced disease (stage III/IV 41% compared with 31%; P<.001). Multivariable analysis demonstrated that uterine carcinosarcoma histology, advanced age, nonwhite race, and advanced stage were independent predictors of poor survival. Cancer-specific mortality was 45% lower in women with grade 3 endometrioid carcinomas (hazard ratio 0.55; 95% confidence interval [CI] 0.5-0.6). The 5-year cancer-specific survival was lower for women with uterine carcinosarcoma for each disease stage. Survival for stage IC was 38% (95% CI 33-45%) for uterine carcinosarcoma compared with 68% (95% CI 63-73%) for grade 3 endometrioid carcinoma. For stage III, survival was 22% (95% CI 19-26%) for uterine carcinosarcoma compared with 45% (95% CI 41-49%) for grade 3 endometrioid carcinoma. CONCLUSION: Carcinosarcomas present at more advanced stage and have worse survival than grade 3 endometrioid carcinomas. Carcinosarcomas may represent a distinct biologic entity. LEVEL OF EVIDENCE: II.

PMID: 18591309 [PubMed - as supplied by publisher]

Carcinosarcoma of the Orbit: Report of Two Cases and Review of the Literature.

Ophthalmology. 2008 Jun 16;

Authors: Prakalapakorn SG, Bernardino CR, Auclair PL, Grossniklaus HE

OBJECTIVE: To report the clinicopathologic features of 2 patients with carcinosarcoma of the orbit. DESIGN: Case reports. PARTICIPANTS: Two patients with orbital carcinosarcoma were identified. METHODS: Retrospective chart review with clinicopathologic correlation and literature review. MAIN OUTCOME MEASURES: Clinical examination, imaging studies, and histopathologic findings. RESULTS: Two patients, a 56-year-old woman and a 91-year-old woman, with orbital carcinosarcoma were identified. Both tumors contained sarcomatous and carcinomatous components and invaded periorbital structures. CONCLUSIONS: Carcinosarcoma may arise in the orbit or extend into the orbit from the paranasal sinuses. This malignant neoplasm should be aggressively treated with a combination of surgical resection, chemotherapy, and radiation therapy.

PMID: 18562006 [PubMed - as supplied by publisher]

So-called Carcinosarcoma of the Esophagus: Report of a Case.

J Nippon Med Sch. 2008 Jun;75(3):171-4

Authors: Akagi I, Miyashita M, Makino H, Nomura T, Ohkawa K, Tajiri T

The carcinosarcoma of the esophagus is a rare malignant neoplasm consisting of both carcinomatous and sarcomatous components. A case of so-called carcinosarcoma of the esophagus is described herein. A 69-year-old man presented with dysphagia and was admitted to our hospital. Imaging studies revealed a localized ulcerative tumor in the middle intrathoracic esophagus without any invasion or metastasis. The patient was initially thought to have squamous cell carcinoma and underwent subtotal esophagectomy with lymphadenectomy. Final diagnosis of the tumor was so-called carcinosarcoma of the esophagus. The patient had an uneventful postoperative course and showed no evidence of recurrence or metastasis in the 4-year postoperative period.

PMID: 18648176 [PubMed - in process]

Carcinosarcoma of the uterus: radiologic-pathologic correlations with magnetic resonance imaging including diffusion-weighted imaging.

Magn Reson Imaging. 2008 May 21;

Authors: Kato H, Kanematsu M, Furui T, Imai A, Hirose Y, Kondo H, Goshima S, Tsuge Y

The authors describe the MRI findings, including diffusion-weighted imaging findings, of histopathologically proven uterine carcinosarcoma in four postmenopausal women. In three of four patients, diffusion-weighted images clearly revealed hypointense areas corresponding to hypocellular regions caused by intratumoral necrosis, and apparent diffusion coefficient (ADC) mapping images indicated that necrotic areas had high ADC values. In the remaining patient, diffusion-weighted and ADC mapping images clearly distinguished components of adenocarcinoma from sarcoma. In all patients, diffusion-weighted and ADC mapping images precisely reflected histopathological findings. Diffusion-weighted images were found to demonstrate complicated tissue components in carcinosarcomas of the uterus, and thus, which may be useful for the diagnosis of this disease.

PMID: 18501546 [PubMed - as supplied by publisher]

[Clinical analysis of 12 cases of uterine carcinosarcoma.]

Ai Zheng. 2008 May;27(5):516-9

Authors: Wang LH, Xiong Y, Li YF, Li JD, Feng YL, Li YJ, Chen C, Chen L

BACKGROUND & OBJECTIVE: Uterine carcinosarcoma, also known as malignant mixed mullerian tumors, is an uncommon neoplasm that carries a poor prognosis. This study was to analyze the clinical manifestation, diagnosis, treatment and prognosis of this disease. METHODS: Clinical data of 12 uterine carcinosarcoma patients, diagnosed in Cancer Center of Sun Yat-sen University from 1978 to 2004, were analyzed. RESULTS: Of the 12 cases of uterine carcinosarcoma, 2 were in the cervix, 10 in the corpus uteri. The main clinical manifestation of cervical carcinosarcoma was contact vaginal bleeding. Carcinosarcoma in the corpus uteri manifested abnormal vaginal bleeding and postmenstrual bleeding. Diagnosis depended on pathology. Twelve patients undergone operation. Eight patients received chemotherapy and 2 received radiotherapy after operation. One cervical carcinosarcoma patient died within 2 year. The 1-, 3-, and 5-year survival rates of the 12 patients were 80.0%, 50.0%, and 50.0%,respectively. CONCLUSIONS: Primary surgery is the main treatment for uterine carcinosarcoma. The prognosis of uterine carcinosarcoma is associated with surgicopathologic stage and treatment modalities.

PMID: 18479602 [PubMed - in process]

Related Articles

Pseudovacuoles--immobilized by high-pressure freezing--are associated with blebbing in walker carcinosarcoma cells.

J Microsc. 2008 May;230(Pt 2):253-62

Authors: Vanhecke D, Bellmann R, Baum O, Graber W, Eggli P, Keller H, Studer D

By applying high pressure freezing and freeze-substitution, we observed large inclusions of homogeneous appearance in the front of locomoting Walker carcinosarcoma cells that have not been described earlier. Live cell imaging revealed that these inclusions were poor in lipids and nucleic acids but had a high lysine (and hence protein) content. Usually one such structure 2-5 mum in size was present at the front of motile Walker cells, predominantly in the immediate vicinity of newly forming blebs. By correlating the lysine-rich areas in fixed and embedded cells with electron microscopic pictures, inclusions could be assigned to confined, faintly stained cytoplasmic areas that lacked a surrounding membrane; they were therefore called pseudovacuoles. After high-pressure freezing and freeze substitution, pseudovacuoles appeared to be filled with 20 nm large electron-transparent patches surrounded by 12 and 15 nm large particles. The heat shock protein Hsp90 was identified by peptide sequencing as a major fluorescent band on SDS-PAGE of lysine-labelled Walker cell extracts. By immunofluorescence, Hsp90 was found to be enriched in pseudovacuoles. Colocalization of the lysine with a potassium-specific dye in living cells revealed that pseudovacuoles act as K+ stores in the vicinity of forming blebs. We propose that pseudovacuoles might support blebbing by locally regulating the intracellular hydrostatic pressure.

PMID: 18445155 [PubMed - indexed for MEDLINE]

Carcinosarcomatous malignancy, osteosarcoma and squamous cell carcinoma, in giant cell tumor of the right distal femur.

Pathol Res Pract. 2008 Apr 24;

Authors: Machinami R, Nishida K, Ishida T, Matsumoto S, Kuroda K, Kobayashi M, Takeuchi K, Ishikawa Y

We report a new type of secondary malignant giant cell tumor of bone, the malignancy of which was assigned to a carcinosarcoma, i.e., osteosarcoma and squamous cell carcinoma. It occurred 25 years after curettage and bone graft surgery under the diagnosis of giant cell tumor of the right distal femur. Although secondary malignant giant cell tumor is known as a sarcoma arising at the site of a previously diagnosed giant cell tumor, this case should be regarded as a new type of secondary malignant giant cell tumor of bone.

PMID: 18440162 [PubMed - as supplied by publisher]

Prophylactic pelvic irradiation as part of primary therapy in uterine sarcomas.

Int J Oncol. 2008 May;32(5):1111-7

Authors: Sorbe B, Johansson B

In a complete geographic series of 155 cases of primary uterine sarcomas, prophylactic pelvic irradiation was used as standard postoperative therapy in the majority of the cases. Vaginal brachytherapy was also added as a boost. The histology was leiomyosarcoma in 62 cases (40%), carcinosarcoma in 60 (39%), endometrial stromal sarcoma in 25 (16%), and other types in 8 cases (5%). The primary surgery was extended hysterectomy in 11 cases (7%), simple hysterectomy in 110 (71%), and supravaginal hysterectomy in 12 (8%). In 22 cases (14%) no major surgery was possible. In the complete series, 62 recurrences (40%) were recorded. Local (9%), regional (9%), and distant recurrences (28%) were the most frequent. The type of surgery was associated with the risk of tumor recurrence. Extended surgery reduced the risk of local and regional recurrences. The 5-year overall survival rate was 42% and the recurrence-free survival (RFS) was 37%. The number of mitoses was significantly (P=0.007) associated with survival. The locoregional RFS rate was 75% for patients treated with adjuvant irradiation and 83% for patients treated with primary surgery alone. Serious late tissue reactions from the bladder and intestine occurred in 7% of the irradiated cases. The locoregional tumor control rate was high in this series of patients, but no significant difference was found between patients treated with surgery alone and surgery plus postoperative pelvic irradiation. This was true for all histological subtypes of the uterine sarcomas. However, this was not a randomized study and selection bias cannot be ruled out.

PMID: 18425339 [PubMed - in process]

[The diagnostic problem of uterine sarcomas: Report on a case of carcinosarcoma mimicking a gastro-intestinal disease.]

J Gynecol Obstet Biol Reprod (Paris). 2008 Apr 11;

Authors: Leung F, Assad F, Aouar Z, Hassan F, Le Guillouzic Y, Riethmuller D

Uterine sarcomas are rare tumours with poor prognosis. The most common presenting symptoms are vaginal bleeding or pelvic pain. We present a case of uterine carcinosarcoma diagnosed retrospectively after surgical specimen analysis in a 69-year-old patient presenting gastro-intestinal complaints. At the time of diagnosis, the patient was in FIGO, stage IV.

PMID: 18407437 [PubMed - as supplied by publisher]

Phase III randomised study to evaluate the role of adjuvant pelvic radiotherapy in the treatment of uterine sarcomas stages I and II: An European Organisation for Research and Treatment of Cancer Gynaecological Cancer Group Study (protocol 55874).

Eur J Cancer. 2008 Mar 28;

Authors: Reed NS, Mangioni C, Malmström H, Scarfone G, Poveda A, Pecorelli S, Tateo S, Franchi M, Jobsen JJ, Coens C, Teodorovic I, Vergote I, Vermorken JB

The management of uterine sarcomas continues to present many difficulties. Primary surgery is the optimal treatment but the role of post-operative radiation remains uncertain. In the mid-1980s, the European Organisation for Research and Treatment of Cancer Gynaecological Cancer Group Study proposed a trial to evaluate adjuvant radiotherapy, as previous non-randomised studies had suggested a survival advantage and improved local control when post-operative radiation was administered. The study opened in 1987 taking 13 years to accrue 224 patients. All uterine sarcoma subtypes were permitted. Patients were required to have undergone as a minimum, TAH and BSO and wahsings (166 patients) but nodal sampling was optional. There were 103 leiomyosarcomas (LMS), 91 carcinosarcomas (CS) and 28 endometrial stromal sarcomas (ESS). Patients were randomised to either observation or pelvic radiation, 51Gy in 28 fractions over 5 weeks. Hundred and twelve were recruited to each arm. The initial analysis has shown a reduction in local relapse (14 versus 24, p=0.004) but no effect on either OS or PFS. No unexpected toxicity was seen in the radiation arm. No difference in either overall or disease-free survival was demonstrated but there is an increased local control for the CS patients receiving radiation but without any benefit for LMS. Prognostic factor analysis shows that stage, age and histological subtype were important predictors of behaviour which may explain differences between CS and LMS. CS appears to show more kinship to poorly differentiated endometrial carcinomas in behaviour. LMS did not show the same benefit from radiation. These results will help shape future management and clinical trials in uterine sarcomas.

PMID: 18378136 [PubMed - as supplied by publisher]