Uterine Papillary Serous Carcinoma: A Single-Institution Review of 62 Cases

Black, Carin; Feng, Amy; Bittinger, Sophie; Quinn, Michael; Neesham, Deborah; McNally, Orla

doi:10.1097/igc.0000000000000569

Cited by 22 publications

(16 citation statements)

References 32 publications

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“…Previous studies 4 , 5 , 7 , 9 , 26 – 33 have evaluated factors such as age, stage, tumor marker, depth of myometrial invasion, tumor size, lymph node involvement, lymphatic vascular space invasion (LVSI), and cytoreductive surgery as prognostic factors of UPSC, but their findings are inconsistent ( Table 6 ). However, most findings 4 , 7 , 9 , 27 , 29 – 31 showed that tumor stage and optimal cytoreduction strongly influence the prognosis of patients with UPSC, which was similar to our result. In the current study, we sought to define which traditional prognostic factors may be clinically important in UPSC patients, whereas multivariate analysis revealed that optimal cytoreduction and tumor stage were the only independent prognostic factors for both PFS and OS ( Table 3 ).…”

Section: Discussionsupporting

confidence: 91%

“…As for the evaluation of other histopathological factors, Slomovitz et al 9 showed that lymph node status, LVSI, and depth of myometrial invasion were all risk factors for a worse prognosis. While a series reported by Black et al 27 suggested that prognosis was only determined by myometrial invasion and tumor stage, a retrospective study conducted by Solmaz et al 28 demonstrated that LVSI is the only independent prognostic factor for OS, whereas LVSI and optimal cytoreduction are independent prognostic factors for PFS in patients with UPSC. The result of multivariate analysis of our study showed that there was no significant difference in survival based on age, depth of myometrial invasion, LVSI, and lymph nodes metastasis.…”

Section: Discussionmentioning

confidence: 98%

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Clinicopathological and survival analysis of uterine papillary serous carcinoma: a single institutional review of 106 cases

Wang¹,

Yu²,

Yang³

et al. 2018

CMAR

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ObjectivesThe objectives of this study were to analyze clinicopathological features and to investigate the prognostic determinants in patients with uterine papillary serous carcinoma (UPSC).Materials and methodsA cohort of 106 UPSC patients diagnosed and treated at Peking Union Medical College Hospital between 2000 and 2016 were retrospectively reviewed. The Kaplan–Meier method and Cox regression analysis were used for survival analysis. Differences between categorical data were calculated by using the chi-squared test.ResultsThe median follow-up was 29.0 months (range =2–170 months), with an overall recurrence rate of 35.8%. The coincidence rate between preoperative endometrial sampling and postoperative definitive pathology of hysteroscopy group was significantly higher than that of the dilation and curettage group (88.5% vs 65.0%, P=0.019). Adjuvant therapy-treated patients with stage I UPSC experienced significantly fewer recurrences than those receiving observation (P=0.003). Patients with advanced-stage UPSC who received combination therapy demonstrated a lower risk of local recurrence compared with those who received chemotherapy alone with a borderline significance (P=0.051). Elevated serum cancer antigen 125 level was associated with advanced-stage disease and recurrence (P<0.001). In multivariate analysis, tumor stage and optimal cytoreduction were independent predictors of survival. In substage analysis, complete surgical staging was associated with better overall survival (OS; yes vs no, HR: 0.05 [95% CI: 0.01–0.51], P=0.037) in patients with stage I UPSC. As for advanced stage, paclitaxel–platinum chemotherapy regimen and optimal cytoreduction were independent favorable prognostic factors for progression-free survival (paclitaxel–carboplatin [TC] vs other; HR =0.38, P=0.010; yes vs no, HR =0.45, P=0.032) and OS (TC vs other, HR =0.38, P=0.022; yes vs no, HR =0.54, P=0.013).ConclusionIn patients with stage I UPSC, complete staging was associated with better OS, and therefore, it should be performed in all patients. Tumor stage and optimal cytoreduction are the most significant prognostic factors. Recurrence can be improved in stage I patients treated with adjuvant therapy and in patients with advanced-stage disease treated with combined therapy. TC regimen may be the preferred regimen for chemotherapy.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 98%

Clinicopathological and survival analysis of uterine papillary serous carcinoma: a single institutional review of 106 cases

Wang¹,

Yu²,

Yang³

et al. 2018

CMAR

View full text Add to dashboard Cite

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“…In our research, compared with EAC, the prognosis of NEC was slightly worse. Compared with other studies, the survival rate of NEC patients in this study was higher [ 8 , 22 , 23 ]. The reasons were as follows: in this research, mixed cell carcinoma was defined as NEC, while studies had shown that the prognosis of mixed cell carcinoma was better than that of simple NEC [ 24 ].…”

Section: Discussioncontrasting

confidence: 77%

Overview of adjuvant radiotherapy on survival, failure pattern and toxicity in stage I to II endometrial carcinoma: a long-term multi-institutional analysis in China

Wang

et al. 2022

BMC Cancer

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Background This research aimed to provide an overview of the impact of adjuvant vaginal brachytherapy (VBT) and external beam pelvic radiotherapy (EBRT) with or without VBT on survival in stage I to II EC patients in China from a long-term multi-institutional analysis. Methods We retrospectively analyzed stage I to II EC patients from 13 institutions treated between 2003 and 2015. All patients underwent surgical staging and received adjuvant RT. Patients were divided into groups of low-risk (LR), intermediate-risk (IR), high-intermediate-risk (HIR) and high-risk (HR). Survival statistics, failure pattern, and toxicity of different radiation modalities in different risk groups were analyzed. Results A total of 1048 patients were included. HR disease represented 27.6%, HIR 17.7%, IR 27.7% and LR 27.1%, respectively. Endometrioid adenocarcinoma (EAC) and non-endometrioid carcinoma (NEC) accounted for 92.8 and 7.2%. A total of 474 patients received VBT alone and 574 patients received EBRT with or without VBT. As for EAC patients, the 5-year overall survival (OS), disease-free survival (DFS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) rate was: 94.6, 90.4, 93.0 and 91.6%, respectively. For LR patients, EBRT (with or without VBT) seemed to be a risk factor. With the higher risk category, the survival benefit of EBRT gradually became remarkable. EBRT (with or without VBT) significantly increased DFS, LRFS and DMFS compared to VBT alone in the HR group (p < 0.05). Distant metastasis was the main failure pattern for all risk groups. As for NEC patients, the 5-year OS, DFS, LRFS and DMFS rate was: 93.4, 87.2, 91.7 and 89.3%, respectively. As for toxicity, EBRT (with or without VBT) significantly increased the incidence of grade 1–2 gastrointestinal, urinary, and hematological toxicity. Conclusions For stage I to II EC patients, EAC accounted for the majority and had better prognosis than NEC. For EAC patients, VBT alone resulted in comparable survival to EBRT in the LR, IR and HIR groups, while EBRT significantly increased survival in the HR group. EBRT had higher rate of toxicity than VBT.

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“…Two different subtypes of EC have been described: type I tumours are mostly endometrioid adenocarcinomas and are associated with unopposed oestrogen stimulation and obesity and are often preceded by endometrial hyperplasia [2]. Type II tumours on the other hand are predominantly serous carcinomas, are commonly described as oestrogen independent arising in atrophic endometrium and are less well differentiated and therefore haver poorer prognosis [2,3]. The large majority of endometrial cancer are type I endometrioid, which is associated with good prognosis [4].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic value of microRNA panel in endometrial cancer: A systematic review

2020

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Purpose: We conducted a systematic review to evaluate the overall diagnostic accuracy of miRNAs in detecting endometrial cancer. Materials and Methods: A systematic search of Medline, Embase, Cinahl and the Cochrane Controlled Register of Trials was performed to identify studies reporting on the diagnostic value of miRNA in EC patients. Included were diagnostic studies looking at miRNA expression in women diagnosed with endometrial cancer. Two reviewers independently selected studies and assessed quality of studies using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) score system. Data extraction was completed and the vote-counting strategy was used to rank miRNAs. Results: 26 studies were included with a total number of 1,400 EC patients reporting on 106 differentially expressed miRNAs. The most frequently found upregulated miRNA was miR-205 followed by miR-200c,-223,-182,-183 and-200a. In addition, miR-135b, miR-429, miR-141 and miR-200b were also frequently upregulated. There was less consensus on down-regulated miRNAs. Conclusions: miRNAs yield a promising diagnostic biomarker potential in endometrial cancer, especially miR-205, the miR-200 family and miR-135b,-182,-183 and-223. However, no sufficient high quality data are available to draw hard conclusions. More research is needed to validate the diagnostic potential of these miRNAs in larger studies. In addition, the potential of urine as a non-invasive biofluid should be investigated in more detail.

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Uterine Papillary Serous Carcinoma: A Single-Institution Review of 62 Cases

Cited by 22 publications

References 32 publications

Clinicopathological and survival analysis of uterine papillary serous carcinoma: a single institutional review of 106 cases

Clinicopathological and survival analysis of uterine papillary serous carcinoma: a single institutional review of 106 cases

Overview of adjuvant radiotherapy on survival, failure pattern and toxicity in stage I to II endometrial carcinoma: a long-term multi-institutional analysis in China

Diagnostic value of microRNA panel in endometrial cancer: A systematic review

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