Influence of postoperative treatment on survival in patients with uterine papillary serous carcinoma

Background. Uterine papillary serous carcinoma (UPSC) is an uncommon, aggre ssive type of endometrial cancer associated with an advanced stage at initi al presentation, rapid progression of disease, and poor prognosis. Methods, Twenty-three patients with UPSC were included in this study. Histo ry, treatment, follow-up, and 5-year overall survival probability (5-yr OS% ) were evaluated, Results. All women underwent total hysterectomy and bilateral salpingo-ooph orectomy. Positive lymph nodes were found in 10 of 17 patients who underwen t pelvic lymphadenectomy. Eight patients had FIGO Stage I/II, whereas 15 pa tients showed Stage III or IV tumors. After surgery 5 women underwent radio therapy, 5 chemotherapy, and 8 both radiotherapy and chemotherapy. Chemothe rapy consisted of cisplatin/carboplatin plus cyclophosphamide, Adjuvant irr adiation consisted of vault and external beam irradiation. The median durat ion of follow-up was 39.4 months (25th and 75th percentiles; 26.1, 68.1). T he median overall survival was 43.3 months (12.9, 75th percentile not reach ed). Three of 10 patients who received only chemotherapy or radiotherapy ar e alive, whereas 7/8 patients who received a combination of both are alive with no evidence of disease at the time of reporting. The 5-yr OS% was 80% in those who received radio- and chemotherapy and only 30% in those who wer e treated with radiotherapy alone (log rank = 0.05), Conclusion. These results stress the need to study and evaluate the usefuln ess of combined chemo- and radiation therapy in patients with uterine serou s papillary cancer. (C) 1998 Academic Press.