Impact of management on the prognosis of pure uterine papillary serous cancer - A Taiwanese Gynecologic Oncology Group (TGOG) study

Chia Yen Huang, Yun Hsin Tang, Ying Cheng Chiang, Kung Liahng Wang, Hung Chun Fu, Yu Min Ke, Hei Yu Lau, Keng Fu Hsu, Ching Hu Wu, Wen Fang Cheng

Research output: Contribution to journalArticlepeer-review

22 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)221-228
Number of pages8
JournalGynecologic oncology
Volume133
Issue number2
DOIs
Publication statusPublished - 2014 May

All Science Journal Classification (ASJC) codes

  • Oncology
  • Obstetrics and Gynaecology

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