In this review, we outline the biology and management of patients with carcinosarcomas and related malignancies, which are often included under the broader concept of sarcomatoid carcinomas. Carcinosarcomas are unusual tumors that are commonly gynecologic in origin, where they are referred to as malignant mixed Müllerian tumors, but may appear in any anatomic site. Although a variety of hypotheses have been presented as to the biphasic nature of these tumors, carcinosarcomas seem to represent the best example in human cancers of the concept of epithelial-mesenchymal transition (EMT), in which the two parts of the tumor are genomically related to one another, as opposed to the mesenchymal component that represents a second neoplasm or (benign) reactive process. In general, patients with carcinosarcomas fare worse than patients with carcinomas of the same anatomic site. Treatment paradigms for carcinosarcomas generally follow those of carcinomas of the same organ site, except where clinical trials provide more specific options. Agents that block or reverse EMT are worth examination in patients with carcinosarcoma and arguably may be even more effective in carcinomas, given evidence of dependence on EMT to generate successful metastases. Information about EMT may also inform other phase transitions in cancer, such as those between prostate or lung carcinoma and more aggressive tumors with neuroendocrine differentiation.

中文翻译：

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癌肉瘤和相关癌症：上皮间质转化过程中的肿瘤

在这篇综述中，我们概述了癌肉瘤和相关恶性肿瘤患者的生物学和管理，它们通常包含在更广泛的肉瘤样癌概念下。癌肉瘤是罕见的肿瘤，通常起源于妇科，在那里它们被称为恶性混合苗勒氏肿瘤，但可能出现在任何解剖部位。尽管关于这些肿瘤的双相性质已经提出了各种假设，但癌肉瘤似乎代表了人类癌症中上皮间充质转化 (EMT) 概念的最佳例子，其中肿瘤的两个部分在基因组上是相关的与代表第二种肿瘤或（良性）反应过程的间充质成分相反。一般来说，癌肉瘤患者比相同解剖部位的癌患者的情况更糟。癌肉瘤的治疗范式通常遵循同一器官部位的癌的治疗范式，除非临床试验提供了更具体的选择。阻断或逆转 EMT 的药物值得对癌肉瘤患者进行检查，并且可以说在癌症中可能更有效，因为有证据表明依赖 EMT 产生成功转移。有关 EMT 的信息还可以告知癌症的其他相变，例如前列腺癌或肺癌与具有神经内分泌分化的更具侵袭性的肿瘤之间的相变。阻断或逆转 EMT 的药物值得对癌肉瘤患者进行检查，并且可以说在癌症中可能更有效，因为有证据表明依赖 EMT 产生成功转移。有关 EMT 的信息还可以告知癌症的其他相变，例如前列腺癌或肺癌与具有神经内分泌分化的更具侵袭性的肿瘤之间的相变。阻断或逆转 EMT 的药物值得对癌肉瘤患者进行检查，并且可以说在癌症中可能更有效，因为有证据表明依赖 EMT 产生成功转移。有关 EMT 的信息还可以告知癌症的其他相变，例如前列腺癌或肺癌与具有神经内分泌分化的更具侵袭性的肿瘤之间的相变。