Article Text

Download PDFPDF
Prognosis for papillary serous carcinoma of the endometrium after surgical staging
  1. D. Semer,
  2. N. P. Nguyen1,
  3. S. Sallah2,
  4. U. Karlsson3,
  5. P. Vos4,
  6. A. Ludin5,
  7. D. Tait6,
  8. M. Salehpour3,
  9. G. Jendrasiak3 and
  10. C. Robiou7
  1. 1 From the Department of Radiation Oncology, Southwestern University, Dallas, Texas;
  2. 2 Division of Hematology/Oncology, University of Tennessee, Memphis, Tennessee;
  3. 3 Department of Radiation Oncology, East Carolina University, Greenville, NC;
  4. 4 Department of Biostatistics, East Carolina University;
  5. 5 Department of Radiation Oncology, Cleveland Clinic Foundation, Cleveland, Ohio;
  6. 6 Division of Gynecologic Oncology and
  7. 7 Department of Pathology, East Carolina University
  1. Address correspondence and reprint requests to: Nam P. Nguyen, MD, Clinical Assistant Professor of Radiation Oncology, Southwestern University School of Medicine, V.A. North Texas Health Care System, South Lancaster Road, Dallas, TX 75216. E-mail:NamPhong.Nguyen{at}


Abstract. Nguyen NP, Sallah S, Karlsson U, Vos P, Ludin A, Semer D, Tait D, Salehpour M, Jendrasiak G, Robiou C. for papillary serous carcinoma of the endometrium after surgical staging.

Background: To investigate the pattern of failure and the prognosis following pathological staging for uterine papillary serous carcinoma (UPSC).

Patients and methods: A retrospective review was conducted of 22 patients with UPSC, treated between 1989 and 1998 at a single institution. All patients were surgically staged. Two patients with advanced disease received chemotherapy only. Two patients with early-stage disease were followed without further treatment. Eighteen patients received postoperative irradiation; eight patients received whole abdominal irradiation (WART), and the remaining 10 patients, pelvic irradiation (PRT). In addition, seven of these patients received vaginal cuff irradiation with low-dose-rate or high-dose-rate brachytherapy. Toxicity, pattern of failure, and survival were evaluated and compared to the literature.

Results: Seven patients (32%) developed distant metastases, three out of seven (42%) after WART. Four out of seven patients who had distant metastases died from disease progression during subsequent chemotherapy. All patients with distant metastases had locally advanced-stage disease at presentation (six stage III, one stage IV). Four patients with pelvic recurrences developed concurrent (2) and subsequent (2) distant metastases. Three patients had isolated distant metastases. No patient with early stage-disease (stage I and II) died from disease progression.

Conclusion: Pathological staging should be performed for all patients with UPSC to determine the prognosis as well as to tailor the treatment. The role of abdominal irradiation in the treatment of UPSC is yet to be determined; however, such an approach may not be necessary for the control of disease for patients with early-stage (I and II) disease. Patients with locally advanced-stage (stage III) disease are at risk of local regional failures and distant metastases despite WART. Therefore, the benefit of WART for advanced-stage disease is also questionable. Paclitaxel-based chemotherapy is currently being investigated in this setting.

  • pathologic staging
  • prognosis
  • uterine papillary serous carcinoma
  • whole abdominal irradiation

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.