Impact of management on the prognosis of pure uterine papillary serous cancer - A Taiwanese Gynecologic Oncology Group (TGOG) study
Journal
Gynecologic Oncology
Journal Volume
133
Journal Issue
2
Pages
221-228
Date Issued
2014
Author(s)
Huang C.-Y.
Tang Y.-H.
Wang K.-L.
Fu H.-C.
Ke Y.-M.
Lau H.-Y.
Hsu K.-F.
Wu C.-H.
Abstract
Objective To investigate the clinical and pathological characteristics and the management of uterine papillary serous carcinoma (UPSC) in relation to patients' outcomes. Methods Clinicopathological data and the management of patients treated between 1991 and 2010 at 11 member hospitals of the Taiwanese Gynecologic Oncology Group (TGOG) were retrospectively reviewed. The Kaplan-Meier method was used to generate survival curves, and factors predictive of outcome were compared using the log-rank test and Cox regression analysis. Results A total of 119 pure UPSC patients were recruited. Stages I, II, III, and IV were identified in 34.5%, 2.5%, 36.1%, and 26.9% of the patients, respectively. The recurrence rate was 20.5% in FIGO stage I/II disease and 55.2% in FIGO stage III/IV disease. The 5-year overall survival rates for the patients with stage I, II, III, and IV disease were 92.0%, 66.7%, 34.2%, and 17.3%, respectively. Multivariate analysis showed that tumor stage (stage III/IV hazard ratio [HR] 8.65, 95% confidence interval [CI] 3.00-24.9) and optimal cytoreduction (HR 0.40, 95% CI 0.22-0.73) independently influenced the overall survival rate of UPSC patients. In addition, optimal cytoreduction (HR 0.36, 95% CI 0.17-0.78) and the combination of chemotherapy and radiation (HR 0.11, 95% CI 0.04-0.37) improved the overall survival of the advanced stage (FIGO stage III/IV) UPSC patients. Conclusions UPSC represents an aggressive subtype of endometrial cancer commonly accompanied by extra-uterine disease. Comprehensive surgical staging with cytoreductive surgery is mandatory and beneficial for UPSC patients. Systemic chemotherapy combined with radiation should be considered as an adjuvant therapy for advanced stage UPSC patients. ? 2014 Elsevier Inc.
SDGs
Other Subjects
CA 125 antigen; doxorubicin; epirubicin; paclitaxel; platinum; abdominal radiotherapy; adult; aged; article; body mass; brachytherapy; cancer adjuvant therapy; cancer chemotherapy; cancer prognosis; cancer radiotherapy; cancer recurrence; cancer staging; clinical feature; diabetes mellitus; electrocorticography; endometrium carcinoma; female; follow up; human; hypertension; lymph node dissection; lymph node metastasis; lymph vessel metastasis; major clinical study; menopause; minimal residual disease; nullipara; outcome assessment; overall survival; postoperative care; priority journal; recurrence risk; retrospective study; survival rate; vaginal brachytherapy; whole pelvic radiotherapy; Adjuvant therapy; Papillary serous carcinoma; Recurrence; Survival; Uterine cancer; Adenocarcinoma, Papillary; Adult; Aged; Aged, 80 and over; Chemoradiotherapy, Adjuvant; Combined Modality Therapy; Disease-Free Survival; Endometrial Neoplasms; Female; Humans; Hysterectomy; Kaplan-Meier Estimate; Middle Aged; Multivariate Analysis; Neoplasm Recurrence, Local; Neoplasm Staging; Prognosis; Proportional Hazards Models; Retrospective Studies; Taiwan; Treatment Outcome; Uterine Neoplasms
Type
journal article