EPIDEMIOLOGICAL, CLINICAL, THERAPEUTIC, AND PROGNOSTIC ASPECTS OF ENDOMETRIAL CARCINOSARCOMA: EXPERIENCE OF THE NATIONAL INSTITUTE OF ONCOLOGY IN RABAT WITH 36 CASES

Endometrial carcinosarcoma is a rare and aggressive cancer, accounting for about 5% of uterine cancers and causing nearly 15% of deaths related to these cancers. It combines epithelial and mesenchymal components and is often diagnosed at an advanced stage. Despite treatments including surgery, chemotherapy, and radiotherapy, the prognosis remains poor, with a median survival of less than 2 years and a 5-year survival rate of less than 30%.This retrospective study analyzed 36 cases of endometrial carcinosarcoma between 2020 and 2023at the National Institute of Oncology in Rabat. The median age at diagnosis was 58 years. The main risk factors identified were menopause, diabetes, and hypertension. Postmenopausal bleeding was the most frequent presenting symptom. Primary treatments included surgery (63%), radiotherapy (38.5%), and chemotherapy (25%). Pathological staging revealed mainly FIGO stage IB (46.15%) and IA (23.07%). The progression rate was 60%, and recurrence occurred in 45% of patients. Overall survival was 43% at 2 years and 27% at 5 years. Although rare, the incidence of ECS is increasing. The prognosis remains poor despite the use of multimodal treatment strategies. Further molecular and therapeutic advances are needed to improve patient outcomes.