470795.fig.005
Figure 5: This flow chart summarizes the current recommendations for the treatment of uterine carcinosarcomas. Due to the rapidly progressive nature of this neoplasm, we recommend adjuvant chemotherapy even in Stage I/II lesions as we believe that the late clinical presentation of these cases is usually associated with silent microscopic disseminated disease. Uncertainties regarding the value of aggressive cytoreductive surgery in Stage IV disease are questionable and indicated with “?”. Similarly, the most effective protocol for chemotherapy is also unknown and indicated by “?”. Likewise, the role for multimodal therapy in this neoplasm is yet to be determined (?).