An analysis of current treatment practice in uterine papillary serous and clear cell carcinoma at two high volume cancer centers

Vogel, Tilley Jenkins; Knickerbocker, A.; Shah, Chirag; Schiff, Melissa A.; Isacson, Christina; Garcia, Rochelle L.; Goff, Barbara A.

doi:10.3802/jgo.2015.26.1.25

Cited by 37 publications

(15 citation statements)

References 28 publications

(48 reference statements)

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“…High-risk histologic carcinomas such as uterine carcinosarcoma and high-grade endometrioid, serous, and clear cell carcinomas, are less prevalent, but are unfortunately significantly more deadly. High-risk carcinomas account for 15% of cases, but are responsible for up to 50% of deaths from endometrial cancer [4,5]. This review will highlight the biologic differences between low- and high-risk carcinomas, focusing on precursor lesions, stem cells, molecular targeted therapies, and model systems.…”

Section: Introductionmentioning

confidence: 99%

Unique Molecular Features in High-Risk Histology Endometrial Cancers

Pandita

Wang

Jones

et al. 2019

Cancers

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Endometrial cancer is the most common gynecologic malignancy in the United States and the sixth most common cancer in women worldwide. Fortunately, most women who develop endometrial cancer have low-grade early-stage endometrioid carcinomas, and simple hysterectomy is curative. Unfortunately, 15% of women with endometrial cancer will develop high-risk histologic tumors including uterine carcinosarcoma or high-grade endometrioid, clear cell, or serous carcinomas. These high-risk histologic tumors account for more than 50% of deaths from this disease. In this review, we will highlight the biologic differences between low- and high-risk carcinomas with a focus on the cell of origin, early precursor lesions including atrophic and proliferative endometrium, and the potential role of stem cells. We will discuss treatment, including standard of care therapy, hormonal therapy, and precision medicine-based or targeted molecular therapies. We will also discuss the impact and need for model systems. The molecular underpinnings behind this high death to incidence ratio are important to understand and improve outcomes.

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Section: Introductionmentioning

confidence: 99%

Unique Molecular Features in High-Risk Histology Endometrial Cancers

Pandita

Wang

Jones

et al. 2019

Cancers

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“…9 Adjuvant chemotherapy has been shown to improve survival in several published studies. [12][13][14]16,29,30 In our series, all chemotherapy regimens contained at least one platinum component, mostly carboplatin. The survival advantage was 32 months, (36 versus four months; P<0.05),…”

Section: Discussionmentioning

confidence: 99%

Analysis of the outcome of patients with stage IV uterine serous carcinoma mimicking ovarian cancer

Al-Aker

Sanday

Nicklin

2019

Preprint

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Objectives: To identify clinicopathological factors that might influence survival in patients with stage IV uterine serous carcinoma, and to compare survival outcomes in patients with stage IV uterine serous carcinoma managed with neoadjuvant chemotherapy followed by interval cytoreduction (with or without adjuvant chemotherapy), primary cytoreductive surgery followed by adjuvant chemotherapy. Methods: A retrospective cohort study of all patients with stage IV Uterine serous carcinoma treated between 2005 and 2015 within a regional cancer centre. Progression-free and overall survival rates were calculated using the Kaplan Meier method. Results: Of 50 women with stage IV uterine serous carcinoma who met inclusion criteria, 37 underwent primary cytoreductive surgery, nine received neoadjuvant chemotherapy with planned interval cytoreductive surgery and four received palliative care only. A pre-treatment diagnosis of stage IV uterine serous carcinoma was made for only 45.9% of the primary cytoreductive surgery group and 56.6% of the neoadjuvant chemotherapy group, with advanced ovarian cancer the most common preoperative misdiagnosis. Median follow up was 19 months. Median overall survival was 27 months for the primary cytoreductive surgery group, 20 months for the neoadjuvant chemotherapy group and two months for the palliative care group. Optimal cytoreduction was achieved in 67.6% of the primary cytoreductive surgery group and 87.5% of the neoadjuvant chemotherapy group who underwent interval cytoreduction. Optimal cytoreduction was associated with improvement in overall survival, compared with suboptimal cytoreduction (36 versus 15 months; P=0.16). Adjuvant chemotherapy was associated with significantly higher overall survival compared with no adjuvant chemotherapy (36 versus four months; P<0.05). Median overall survival was 16 months for those with pure uterine serous carcinoma (n=40), compared with 32 months for those with mixed histopathology (n=10). Conclusion: Stage IV uterine serous carcinoma can mimic advanced ovarian cancer. It carries a poor prognosis, which is worse for pure uterine serous carcinoma than for mixed-type endometrial adenocarcinoma. Neoadjuvant chemotherapy followed by interval cytoreduction and adjuvant chemotherapy seems to be a safe option, with an increased rate of optimal cytoreduction and comparable overall survival, compared with primary cytoreductive surgery. Adjuvant chemotherapy significantly improves survival in all groups.

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“…The effect of surgical approach on the outcomes and prognosis of high-risk histologic endometrioid carcinomas tumors account for more than 50% of endometrioid carcinoma deaths (2,(4)(5)(6). They have high malignancy rates and poor prognoses, and are liable to distant metastasis, yet are difficult to detect early (7,8).…”

Section: Original Articlementioning

confidence: 99%

The effect of surgical approach on the outcomes and prognosis of high-risk histologic endometrioid carcinomas

Han¹,

Zheng

Tao³

et al. 2021

Gland Surg

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Background: High-risk histologic endometrioid carcinomas include poorly differentiated endometrial carcinoma (PDEC), uterine clear cell carcinoma (UCCC), uterine carcinosarcoma (UCS), and uterine papillary serous carcinomas (UPCS). The purpose of this study was to investigate and compare the effect of open surgery and minimally invasive surgery on the prognosis of patients with high-risk endometrial cancer tissue types. Methods: A retrospective analysis was conducted to investigate 57 UCS or UPCS, 53 UCCC, and 110 PDEC patients receiving initial treatment at the Department of Gynecology in Shaanxi Provincial Tumor hospital and the Affiliated Hospital of Medical College of Xi'an Jiaotong University between February 2010and January 2015. Prognostic factors were determined using univariate/multivariate analysis, and survival rates were assessed using the Kaplan-Meier method. The Cox regression model was adopted to assess the independent prognostic factors.Results: Two hundred and twenty patients who met the criteria were included in this study. At the end of follow-up period, 94 patients were still alive. Univariate analysis found that the survival time of the patients was related to staging, adjuvant therapy, and surgical approach. Multivariate analysis revealed that surgical approach, staging, pathology, and adjuvant therapy were independent prognostic factors.Conclusions: Minimally invasive surgery has a shorter survival time compared to open surgery in women with PDEC, UCCC, UCS, and UPCS. Multivariate analysis confirmed that staging, pathological type, surgical approach, and postoperative adjuvant therapy are independent risk factors for prognosis and affect the survival of women with PDEC, UCCC, UCS, and UPCS.

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An analysis of current treatment practice in uterine papillary serous and clear cell carcinoma at two high volume cancer centers

Cited by 37 publications

References 28 publications

Unique Molecular Features in High-Risk Histology Endometrial Cancers

Unique Molecular Features in High-Risk Histology Endometrial Cancers

Analysis of the outcome of patients with stage IV uterine serous carcinoma mimicking ovarian cancer

The effect of surgical approach on the outcomes and prognosis of high-risk histologic endometrioid carcinomas

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