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Gynecologic Cancer InterGroup (GCIG) Consensus Review for Uterine Serous Carcinoma
  1. Satoru Sagae, MD, PhD*,
  2. Nobuyuki Susumu, MD,
  3. Akila N. Viswanathan, MD,
  4. Daisuke Aoki, MD,
  5. Floor J. Backes, MD§,
  6. Diane M. Provencher, MD,
  7. Michelle Vaughan, MD,
  8. Carien L. Creutzberg, MD#,
  9. Christian Kurzeder, MD**,
  10. Gunnar Kristensen, MD, PhD,,
  11. Chulmin Lee, MD,,
  12. Jean-Emmanuel Kurtz, MD§§,
  13. Rosalind M. Glasspool, MBBS, PhD, FRCP∥∥ and
  14. William Small, MD¶¶
  1. *Department of Obstetrics & Gynecology, JR Sapporo Hospital, Sapporo, Japan;
  2. Department of Obstetrics & Gynecology, School of Medicine, Keio University, Tokyo;
  3. Radiation Oncology, Dana-Farber/Brigham and Women’s Cancer Center, Harvard Medical School, Boston, MA;
  4. §Department of Obstetrics and Gynecology, Ohio State University College of Medicine, Columbus, OH;
  5. Centre Hospitalier de L’Université de Montréal, Montreal, Quebec, Canada;
  6. Oncology Department, Christchurch Hospital, Canterbury, New Zealand;
  7. #Department of Clinical Oncology, Leiden University Medical Center, Leiden, the Netherlands;
  8. **Department Gynecology & Gynecologic Oncology, Kliniken Essen Mitte (KEM) (AGO), Essen, Germany;
  9. ††Norwegian Radium Hospital, Oslo, Norway;
  10. ‡‡Department of Obstetrics and Gynecology, Inje University Sanggye Paik Hospital, Seoul, South Korea;
  11. §§Department of Oncology and Hematology, Hôpitaux Universitaires de Strasbourg, Strasbourg, France;
  12. ∥∥Beatson West of Scotland Cancer Centre, Glasgow, Scotland; and
  13. ¶¶Department of Radiation Oncology, Stritch School of Medicine Loyola University, Chicago, IL.
  1. Address correspondence and reprint requests to Satoru Sagae, MD, PhD, Department of Obstetrics and Gynecology, JR Sapporo Hospital, North 3 East 1, Chuou-ku, Sapporo 060-0033 Japan. E-mail: s-sagae{at}jrhokkaido.co.jp.

Abstract

Objectives Uterine serous carcinoma (USC) represents a rare and aggressive histologic subtype of endometrial cancer, associated with a poor prognosis. This article critically reviews the literature pertinent to the epidemiology, pathology, molecular biology, diagnosis, management, and perspectives of patients with USC.

Methods As one of a series of The Gynecologic Cancer InterGroup (GCIG) Rare Tumor Working Group in London, November 2013, we discussed about USC many times with various experts among international GCIG groups.

Results Both USC and approximately 25% of high-grade endometrioid tumors represent extensive copy number alterations, few DNA methylation changes, low estrogen and progesterone levels, and frequent P53mutations. Uterine serous carcinoma shares molecular characteristics with ovarian serous and basal-like breast carcinomas. In addition to optimal surgery, platinum- and taxane-based chemotherapy should be considered in the treatment of both early- and advanced-stage disease. The combination of radiation and chemotherapy appears to be associated with the highest survival rates. The role of radiation therapy in the management of this disease, with a high propensity for distant failures, remains elusive.

Conclusions Uterine serous carcinoma is a unique and biologically aggressive subtype of endometrial cancer and should be studied as a distinct entity. Futures studies should identify the optimized chemotherapy and radiation regimens, sequence of therapy and schedule, and the role of targeted biologic therapy.

  • Uterine serous carcinoma
  • GCIG
  • Review

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Footnotes

  • The authors declare no conflicts of interest.

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