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Role of Adjuvant Chemotherapy in Patients With Early Stage Uterine Papillary Serous Cancer
  1. Ali Mahdavi, MD*,,
  2. Tania R. Tajalli, MD,
  3. Ahmed Dalmar, MD,
  4. Steven A. Vasilev, MD,
  5. Scott E. Lentz, MD and
  6. Michael L. Berman, MD*
  1. *Division of Gynecologic Oncology, University of California Irvine, Orange, CA;
  2. Division of Gynecologic Oncology and Clinical Research,Aurora Health Care, Milwaukee, WI; and
  3. Southern California Permanente Medical Group, Los Angeles, CA.
  1. Address correspondence and reprint requests to Ali Mahdavi, MD, 1218 W Kilbourn Ave, Suite 401, Milwaukee, WI 53233. E-mail: ali.mahdavi{at}aurora.org.

Abstract

Objective: Uterine papillary serous carcinoma (UPSC) is an aggressive subtype of endometrial cancer. We studied survival outcomes in patients with stages I/II UPSC.

Materials: A retrospective, multi-institutional study of patients with stages I/II UPSC was conducted. Patients underwent surgical staging followed by observation, adjuvant platinum-based chemotherapy (CT), or radiation therapy (RT). Continuous variables were compared via Wilcoxon rank sum test; Fisher exact test was used for the unordered categorical variables. Kaplan-Meier curves were used to estimate survival.

Results: Thirty-nine women were diagnosed with stage I (n = 30) or II (n = 9) UPSC, with a median follow-up of 52 months. Of the 26 patients who did not receive adjuvant CT, 9 developed recurrences and 8 died of their disease. Of the 10 patients with no myometrial invasion who did not receive adjuvant CT, 3 developed recurrences and died. Of the 7 patients who underwent RT, 2 developed distant recurrences and died. Of the 13 patients who underwent CT, 1 developed vaginal recurrence. The 5-year overall (OS) and progression-free survival (PFS) rates for the adjuvant CT group were 100% and 92%, respectively, compared with 69% and 65% for those who did not receive CT (P = 0.002 OS, P = 0.002 PFS). The 5-year OS and PFS rates for RT group were both 71%.

Conclusions: Patients with stages I/II UPSC are at significant risk for distant recurrence and poor survival. Platinum-based adjuvant CT may decrease recurrence rate and improve survival in women with early and well-staged UPSC.

  • Uterine papillary serous carcinoma
  • Adjuvant chemotherapy

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Footnotes

  • The authors declare that there are no conflicts of interest.

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