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Analysis of Treatment Failures and Survival of Patients With Uterine Papillary Serous Carcinoma: A Cooperation Task Force (CTF) Study
  1. Angiolo Gadducci, MD*,
  2. Stefania Cosio, MD*,
  3. Fabio Landoni, MD,
  4. Tiziano Maggino, MD,
  5. Paolo Zola, MD§,
  6. Luca Fuso, MD§ and
  7. Enrico Sartori, MD
  1. *Department of Procreative Medicine, Division of Gynecology and Obstetrics, University of Pisa, Pisa;
  2. Division of Gynecology, European Institute of Oncology (EIO), Milan;
  3. Unit of Gynecology and Obstetrics, Umberto I Hospital, Venice-Mestre;
  4. §Department of Gynecology and Obstetrics, University of Turin, Mauriziano Hospital, Turin; and
  5. Department of Gynecology and Obstetrics, University of Brescia, Brescia, Italy.
  1. Address correspondence and reprint requests to Angiolo Gadducci, MD, Department of Procreative Medicine, Division of Gynecology and Obstetrics, University of Pisa, Via Roma 56, Pisa, 56127, Italy. E-mail: a.gadducci{at}obgyn.med.unipi.it.

Abstract

Objective To assess the pattern of failures and the survival of patients with uterine papillary serous carcinoma (UPSC).

Methods The hospital records of 119 women with UPSC were reviewed. Surgery was the initial therapy for all the cases. The median follow-up of survivors was 133 months (range, 3–216 months).

Results Postoperative treatment was used in 98 patients (82.4%). Adjuvant treatment was radiotherapy in 25 women, chemotherapy in 61 women, and chemotherapy plus radiotherapy in 12 women. Tumor recurred in 44 (37.0%) of the 119 patients, after a median time of 15.1 months. Relapse was symptomatic in 15 patients (34.1%), and recurrent disease involved peritoneum or distant sites in 26 (66.7%) of the 39 patients for whom the site of failure was known. Five- and 10-year survival rates were 61.8% and 54.6%, respectively. Survival was related to disease stage (P < 0.0001). Among patients with advanced tumor, 5-year survival was lower in women who had macroscopic residual disease after surgery than in those who had not (15.4% vs 37.5%; P = 0.08). Distant failures were higher in women with histologically proven positive nodes than in those with negative nodes (28.6% vs 9.1%; P = 0.048). There was a trend to better survival for patients with stage I to stage II disease who underwent chemotherapy when compared with those who did not.

Conclusions Uterine papillary serous carcinoma has an aggressive clinical behavior with a great tendency to recur especially in peritoneal and distant sites. Tumor stage is a strong prognostic factor, whereas the role of adjuvant treatment is still uncertain.

  • Uterine papillary serous carcinoma
  • Surgical staging
  • Chemotherapy
  • Radiotherapy
  • Pattern of failure

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Footnotes

  • The authors declare no conflict of interest.

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