UTERINE PAPILLARY SEROUS CARCINOMA - A CLINICAL-STUDY

Background. Uterine papillary serous carcinoma (UPSC) is a histologic subtype of endometrial adenocarcinoma that is characterized by its pap illary architecture, poor differentiation, and advanced stage at initi al presentation. It behaves more aggressively than the more common end ometrioid adenocarcinoma of the endometrium. Methods. The history, tre atment and follow-up of 18 women with UPSC were evaluated. Results. Al l women underwent total hysterectomy and bilateral salpingoophorectomy . Positive lymph nodes were found in 6 of 14 patients who underwent pe lvic lymphadenectomy. Twelve of 18 women with UPSC had FIGO Stage III and IV tumors in contrast to 30 of 236 patients with endometrioid aden ocarcinoma (P < 000.1). Subsequent treatment of these women was: radio therapy, three women; chemotherapy, four, both radiotherapy and chemot herapy, eight. Chemotherapy consisted of cisplatin/carboplatin plus cy clophosphamide. None of the patients with Stage I or II UPSC died of t umor during a mean follow-up of 31.6 months (range, 12-68 months). Of the women with Stage III and IV disease, 4 of 12 are alive with no evi dence of disease after a mean follow-up of 22.5 months (range, 8-45 mo nths). Eight of 12 women who received chemotherapy are alive with no e vidence of disease, 4 of whom had Stage III or IV disease. One of six women who did not receive chemotherapy is alive, three died of tumor, and two of intercurrent disease. Conclusion. These results would justi fy further study of the possible role of platinum-based chemotherapy i n patients with uterine papillary serous carcinoma.