Article

Uterine Papillary Serous Carcinoma: Evaluation of Long-Term Survival in Surgically Staged Patients

Virginia Mason Medical Center, Seattle, Washington, United States
Gynecologic Oncology (Impact Factor: 3.69). 05/1998; 69(1):69-73. DOI: 10.1006/gyno.1998.4956
Source: PubMed

ABSTRACT Earlier studies have demonstrated that the uterine papillary serous carcinoma (UPSC) variant of endometrial carcinoma has a high recurrence rate, even when disease is apparently confined to the uterus. The current study evaluated survival in patients with surgically staged UPSC.
Patients with UPSC were identified from surgical pathology files and charts were retrospectively reviewed. Only patients who had undergone a TAH-BSO, lymph node dissection, and peritoneal cytology were included.
The FIGO stages of the 36 patients were 12 Stage I (4 IA, 4 IB, 4 IC), 2 Stage IIB, 13 Stage III (5 IIIA, 8 IIIC), and 9 Stage IV. Of the 14 Stage I/II patients, 6 did not receive adjuvant therapy, 5 received whole pelvic radiation (WPXRT), and 3 received whole abdominal radiation therapy (WART); after a median follow-up interval of 50 months only 2 (14%) of these Stage I/II patients have developed a recurrence. Both of the recurrences were in Stage IC patients who received radiation; 1 recurred in the radiation field. Of the 5 Stage IIIA patients, 3 patients declined therapy and 2 were treated with WART; 3 patients, including the 2 who received radiation therapy, are alive without disease. Of the 8 Stage IIIC patients, 2 declined postoperative therapy, 2 received WART, and 4 received WPXRT with an extended field to include paraaortic nodes. Four of the 6 Stage IIIC patients treated with curative intent are without evidence of disease and 1 died of unrelated causes after a median follow-up interval of 48 months. Both of the Stage IIIC patients who declined treatment recurred. Of the 9 patients with Stage IV disease, 8 have died of disease.
Women with UPSC have a good prognosis when surgical staging confirms that disease is confined to the uterus (Stage I/II). Surgical findings can also be used to tailor adjuvant radiation treatments. Further study is required to define the optimal treatment for women with metastatic UPSC.

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    • "However, most patients did not undergo surgical evaluation of regional lymph nodes in such studies. On the other hand, some studies reported that the 5-year survival rates were more than 80% in FIGO stages I–II uterine papillary serous carcinoma confirmed by surgical evaluation of lymph nodes [14] [15]. "
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    • "In contrast, data from our prior report and the current study suggest that these histopathologic factors might have a prognostic value in this patient population [34]. Further variables including age at diagnosis, stage of disease and surgical treatment have been shown to impact outcome of USC patients as well [38] [39] [40]. "
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