Management of advanced-stage uterine serous carcinoma (USC) is uncertain, and postsurgical therapeutic options swing between radiation and chemotherapy. The aim of this study is to evaluate the utility of radiotherapy compared to platinum-based chemotherapy in women with advanced-stage USC. We retrospectively identified cases of USC at our institution. Survival distributions were calculated by the Kaplan-Meier method. Two-tailed t-tests were used to compare time to progression and time to death. We identified 24 women diagnosed with either stage III or IV USC. Time to progression for women receiving radiotherapy was 5.3 months as compared with 12.4 months for women receiving chemotherapy (P = 0.01). Mean time to death for the radiotherapy group was 8 months compared to 18 months in the chemotherapy group (P = 0.04). Kaplan-Meier survival curves were significantly different between the two groups (P = 0.01). While radiotherapy appears to control USC recurrences in the pelvis, the disease often recurs distantly. When compared to radiotherapy, platinum-based chemotherapy appears to increase disease-free survival and time to death in women with advanced-stage USC.
Objective-To evaluate prognostic risk factors for survival in women with low grade serous epithelial ovarian cancer (LGSC). Methods-A multicenter retrospective analysis of patients with LGSC was conducted. Potential epidemiologic risk factors evaluated included obesity, age, parity, race, smoking, oral contraceptive pill and/or hormonal replacement therapy use, and previous hysterectomy or surgery on fallopian tubes and/or ovaries. Additional factors included stage, extent of debulking, residual disease, and disease status. Results-Eighty-one patients were identified, and pathological diagnosis was independently confirmed. Median age of diagnosis was 56 years (range: 21 to 86). Thirty-four percent were obese, and 80% had optimally debulked disease. Forty-six percent were alive, 14% with disease; while 25% were dead of disease; 2% died of intercurrent disease; and 27% had an unknown status. In a univariate analysis, optimal surgical debulking was associated with improved PFS (p=0.01), DSS (p=0.03), and OS (p<0.001 and BMI with worse OS (p=0.05). On multivariate analysis, obesity (HR=2.8; 95% CI=1.05-7.3; p=0.04) and optimal tumor debulking (HR=0.05; 95% CI=0.008-0.29; p=0.001) were a significant predictor of OS. Conclusions-In a multivariate analysis, obesity and optimal tumor cytoreduction were significant predictors of OS. However, obesity was not associated with worse DSS, suggesting
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