Stage II uterine papillary serous carcinoma: Carboplatin/paclitaxel chemotherapy improves recurrence and survival outcomes

Fader, Amanda N.; Nagel, Christa; Axtell, Allison E.; Zanotti, Kristine; Kelley, Joseph L.; Moore, Kathleen N.; Secord, Angeles Alvarez; Walsh, Christine; Huh, Warner K.; Gehrig, Paola A.; Gibbons, Heidi E.; Rose, Peter G.; Havrilesky, Laura J.; Tuller, Erin; Drake, Richard D.; Bottsford-Miller, Justin; O’Malley, David M.

doi:10.1016/j.ygyno.2008.11.016

Cited by 79 publications

(57 citation statements)

References 17 publications

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“…We found a five-year overall survival of between 53% and 58% for early-stage, and from 0-39% for advanced-stage (III and IV), disease. 6,[13][14][15][16][17][18][19] The median age of our patient with USC at the time of diagnosis was similar to that seen in other studies, but older than the median age of women with endometrioid uterine cancer. 4,6,11,[20][21][22] Abnormal uterine bleeding was the most common clinical presentation with USC, just as it is in endometrioid uterine cancer.…”

Section: Discussionsupporting

confidence: 77%

“…This recurrence rate is similar to that reported in other studies. [14][15][16][17][18] The recurrence rates were higher in patients who received chemotherapy only, possibly owing to the fact that only patients with advanced-stage disease (III and IV) received chemotherapy as a single treatment modality. As in other studies, recurrence risk correlated with the stage of disease.…”

Section: Discussionmentioning

confidence: 99%

“…As in other studies, recurrence risk correlated with the stage of disease. 6,[13][14][15][16][17][18][19] Relapse rates varied from 23% for stage I, to 100% for stage IV, patients. No significant difference could be demonstrated for recurrence rates relating to the adjuvant treatment that patients with different stages of disease received.…”

Section: Discussionmentioning

confidence: 99%

“…6,[9][10][11][12] Survival varies with each stage, from 45-90% for early-stage (I and II), and 0-30% for advanced stage (III and IV), disease. 6,[13][14][15][16][17][18][19] These tumours are not well understood owing to the low incidence and limited data published thereon. Surgery is the cornerstone of treatment, but a lack of prospective studies leaves uncertainty as to the role of adjuvant therapy.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Adjuvant treatment, tumour recurrence and the survival rate of uterine serous carcinomas: a single-institution review of 62 women

Pol

Allen

Bekkers

et al. 2015

Southern African Journal of Gynaecological Oncology

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Adjuvant treatment, tumour recurrence and the survival rate of uterine serous carcinomas: a single-institution review of 62 women

Pol

Allen

Bekkers

et al. 2015

Southern African Journal of Gynaecological Oncology

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“…Progression free survival (PFS) and OS for stage I-II were 65.5 6 3.6 and 76.5 6 4.3 months, respectively. Other retrospective studies in USC have shown improved PFS but no difference in OS [18]. …”

Section: High-risk Diseasementioning

confidence: 81%

Adjuvant Therapy in Early-Stage Endometrial Cancer: A Systematic Review of the Evidence, Guidelines, and Clinical Practice in the U.S.

et al. 2014

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Endometrial cancer is the most common gynecologic malignancy in the U.S., with an increasing incidence likely secondary to the obesity epidemic. Surgery is usually the primary treatment for early stage endometrial cancer, followed by adjuvant therapy in selected cases. This includes radiation therapy [RT] with or without chemotherapy, based on stratification of patients into categories dependent on their future recurrence risk. Several prospective trials (PORTEC-1, GOG#99, and PORTEC-2) have shown that the use of adjuvant RT in the intermediate risk (IR) and the high-intermediate risk (HIR) groups decreases locoregional recurrence (LRR) but has no effect on overall survival. The ad hoc analyses from these studies have shown that an even larger LRR risk reduction was seen within the HIR group compared with the IR group. Vaginal brachytherapy is as good as external beam radiotherapy in controlling vaginal relapse where the majority of recurrence occur, and with less toxicity. In the high-risk group, multimodality therapy (chemotherapy and RT) may play a significant role. Although adjuvant RT has been evaluated in many cost-effectiveness studies, highquality data in this area are still lacking.The uptake of the above prospective trial results in the U.S. has not been promising. Implications for Practice: Several phase III randomized controlled trials have shown that adjuvant radiation for highintermediate risk early-stage endometrial cancer confers a benefit by reducing local regional recurrence with minimal added toxicity, but at increased cost and without significant overall survival benefit. This article reviews key trials regarding adjuvant radiation in early stage endometrial cancer and summarizes current clinical practice patterns and available guidelines. These facets must be considered and reviewed with each patient individually to determine the relative benefit to each patient.

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A novel model to predict cancer‐specific survival in patients with early‐stage uterine papillary serous carcinoma (UPSC)

Chen

Liu

et al. 2019

Cancer Medicine

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Objective: Stage I-II uterine papillary serous carcinoma (UPSC) has aggressive biological behavior and leads to poor prognosis. However, clinicopathologic risk factors to predict cancer-specific survival of patients with stage I-II UPSC were still unclear.This study was undertaken to develop a prediction model of survival in patients with early-stage UPSC. Methods: Using Surveillance, Epidemiology, and End Results (SEER) database, 964 patients were identified with International Federation of Gynecology and Obstetrics (FIGO) stage I-II UPSC who underwent at least hysterectomy between 2004 and 2015. By considering competing risk events for survival outcomes, we used proportional subdistribution hazards regression to compare cancer-specific death (CSD) for all patients. Based on the results of univariate and multivariate analysis, the variables were selected to construct a predictive model; and the prediction results of the model were visualized using a nomogram to predict the cancer-specific survival and the response to adjuvant chemotherapy and radiotherapy of stage I-II UPSC patients. Results: The median age of the cohort was 67 years. One hundred and sixty five patients (17.1%) died of UPSC (CSD), while 8.6% of the patients died from other causes (non-CSD). On multivariate analysis, age ≥ 67 (HR = 1.45, P = .021), tumor size ≥ 2 cm (HR = 1.81, P = .014) and >10 regional nodes removed (HR = 0.52, P = .002) were significantly associated with cumulative incidence of CSD. In the age ≥67 cohort, FIGO stage IB-II was a risk factor for CSD (HR = 1.83, P = .036), and >10 lymph nodes removed was a protective factor (HR = 0.50, P = .01). Both adjuvant chemotherapy combined with radiotherapy and adjuvant chemotherapy alone decreased CSD of patients with stage I-II UPSC older than 67 years (HR = 0.47, P = .022; HR = 0.52, P = .024, respectively). The prediction model had great risk stratification ability as the high-risk group had higher cumulative incidence of CSD than the low-risk group (P < .001). In the high-risk group, patients with post-operative adjuvant chemoradiotherapy had improved CSD compared with patients who | 989 CHEN Et al.

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Stage II uterine papillary serous carcinoma: Carboplatin/paclitaxel chemotherapy improves recurrence and survival outcomes

Cited by 79 publications

References 17 publications

Adjuvant treatment, tumour recurrence and the survival rate of uterine serous carcinomas: a single-institution review of 62 women

Adjuvant treatment, tumour recurrence and the survival rate of uterine serous carcinomas: a single-institution review of 62 women

Adjuvant Therapy in Early-Stage Endometrial Cancer: A Systematic Review of the Evidence, Guidelines, and Clinical Practice in the U.S.

A novel model to predict cancer‐specific survival in patients with early‐stage uterine papillary serous carcinoma (UPSC)

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