Uterine papillary serous carcinoma (UPSC) treated with cisplatin, doxorubicin, and cyclophosphamide (PAC)

Levenback, C.; Burke, T.; Silva, E; Morris, Michelle Frances; Gershenson, D. M.; Jj, Kavanagh; Jt, Wharton

doi:10.1016/0020-7292(93)90575-h

Cited by 14 publications

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“…However, given that: (1) USPC likely arise from metaplastic Mullerian epithelium, while OSPC likely derive from the ovarian surface epithelium, and (2) a dramatic difference in response to standard chemotherapy regimens is commonly reported among these histologically indistinguishable serous carcinomas (Levenback et al, 1992;Sherman et al, 1992;Carcangiu and Chambers, 1995;Nicklin and Copeland, 1996;Kalil and McGuire 2002), a significant diversity in gene expression among these tumours is probable. In agreement with this view, all five USPC patients evaluated in this study either developed progressive disease during chemotherapy or recurred within 6 months from the end of treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Histologically indistinguishable to high-grade serous ovarian carcinoma (Carcangiu and Chambers, 1992;Sherman et al, 1992), uterine serous papillary cancer (USPC) has a propensity for early intraabdominal, lymphatic and distant metastatic spread even at presentation (Carcangiu and Chambers, 1992;Goff et al, 1994;Nicklin and Copeland, 1996) and is characterised by a highly aggressive biological behavior (Deligdisch and Holinka, 1987;Carcangiu and Chambers, 1992;Sherman et al, 1992;Goff et al, 1994;Nicklin and Copeland, 1996). Unlike OSPC, however, which is responsive to first-line combined cisplatinum-based chemotherapy in 70 -80% of the cases (Kalil and McGuire, 2002), USPC is a chemotherapyresistant disease from outset, with responses to cytostatic agents in the order of 20% and of short duration (Levenback et al, 1992;Carcangiu and Chambers, 1995;Nicklin and Copeland, 1996).…”

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confidence: 99%

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Discrimination between uterine serous papillary carcinomas and ovarian serous papillary tumours by gene expression profiling

et al. 2004

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Section: Discussionmentioning

confidence: 99%

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Discrimination between uterine serous papillary carcinomas and ovarian serous papillary tumours by gene expression profiling

et al. 2004

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“…10,[15][16][17][18] Within any endometrial tumor, serous histologic components are frequently admixed with the more common endometrioid histology. Exactly what percentage of serous component is necessary before its presence becomes a negative prognostic indicator is to our knowledge unknown.…”

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Uterine serous and grade 3 endometrioid carcinomas

Boruta

Gehrig

Groben

et al. 2004

Cancer

100

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BACKGROUNDSerous components within endometrial carcinoma are reportedly poor prognosticators. However, to the authors' knowledge the percentage of tumors which must be comprised of a serous component in order to affect outcome is unknown. The authors compared overall survival (OS) in women with endometrial carcinomas comprised of various percentages of uterine serous carcinoma (USC) with that of women with International Federation of Gynecology and Obstetrics (FIGO) Grade 3 endometrioid carcinoma (G3EC) to determine whether outcomes varied between these two poorly differentiated histologies.METHODSData concerning women with either G3EC or USC who were diagnosed between January 1990 and November 2000 were collected retrospectively. Cases were reviewed to confirm diagnosis and estimate the fraction of tumor comprised of USC. Variables assessed included patient age and race, tumor stage, and lymphovascular space invasion. Associations between variables were tested using the Fisher exact test. The Kaplan–Meier method was used to evaluate OS with comparisons performed using the log‐rank test.RESULTSFifty‐two women with G3EC and 87 women with USC were identified. The OS of women with tumors comprised of > 50% USC was found to be significantly worse compared with women with G3EC (hazard ratio [HR] of 2.4; 95% confidence interval [95% CI], 1.2–5.2). Women with USC were more likely to present with extrauterine disease (odds ratio of 2.2; 95% CI, 1.1–4.5). The 5‐year survival rate for women with G3EC was 75% compared with 41% for women with tumors that were > 50% USC (P = 0.01). There was a significant trend toward a worse OS in women with even 10% USC compared with women with G3EC.CONCLUSIONSUSC involving > 50% of an endometrial carcinoma was found to be predictive of worse OS compared with the OS of women with G3EC. In patients with early‐stage disease, a trend toward a worse prognosis was found to exist when USC comprised even 10% of a tumor. Investigation into the treatment of endometrial carcinoma should include and document tumors with any percentage comprised of USC. Cancer 2004. © 2004 American Cancer Society.

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“…Uterine endometrioid adenocarcinomas (UEA) are usually accompanied by endometrial hyperplasia and typically are low grade, are early stage, and have favorable prognosis. Uterine papillary serous adenocarcinomas (UPSA) usually develop in an atrophic endometrium; are high grade; are advanced stage, and do not respond to conventional chemotherapy, radiotherapy, and hormone therapy (4,5). Recently, a dualistic model of carcinogenesis has been proposed on the basis of the distinctive clinical and histologic features of endometrioid and serous adenocarcinoma (6).…”

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Immunohistochemical Profile of Endometrial Adenocarcinoma: A Study of 61 Cases and Review of the Literature

et al. 2000

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The differences in immunohistochemical expression of p53, bcl-2, bax, estrogen receptor (ER), and progesterone receptor (PR) were evaluated in 40 endometrioid and 21 papillary serous carcinomas of endometrium and correlated with known predictors of survival, such as grade and stage. Uterine papillary serous adenocarcinomas (UPSA) showed significantly higher p53 expression than did uterine endometrioid adenocarcinomas (UEA) (76.2% versus 35%), whereas both ER and PR were more often positive in endometrioid than in serous tumors (p ‫؍‬ .005 and .0005). No significant difference was found in bcl-2 and bax expression between both histologic types. However, there was definite decrease in intensity of bcl-2 in UPSA compared with UEA. In endometrioid carcinoma, p53 overexpression was associated with high-grade and advanced-stage tumors (p ‫؍‬ .0006 and .006), whereas ER and PR expression was associated with low-grade and earlystage tumors (p ‫؍‬ .0006 and .0001; p ‫؍‬ .003 and .0006). Bcl-2 immunopositivity was more common in low-grade, early-stage rather than in high-grade, advanced-stage adenocarcinomas, but the difference was not statistically significant (p ‫؍‬ .24 and .07). Bax immunopositivity was associated with well-differentiated (p ‫؍‬ .04) and early-stage tumors. Furthermore, a significant inverse relationship between bax and p53 reactivity was defined (p ‫؍‬ .05), especially in tumors of endometrioid type. Bax and PR immunoexpression correlated near the limit of statistical significance (p ‫؍‬ .08), whereas no relationship was found among bax, bcl-2, and ER Endometrial adenocarcinoma (EA) is the most common gynecologic malignancy (1). Traditional factors associated with its prognosis include patient's age, tumor grade, stage, histologic type, and the depth of myometrial invasion. Two histologic types of EA-endometrioid and papillary serousare associated with different biologic behavior (2, 3). Uterine endometrioid adenocarcinomas (UEA) are usually accompanied by endometrial hyperplasia and typically are low grade, are early stage, and have favorable prognosis. Uterine papillary serous adenocarcinomas (UPSA) usually develop in an atrophic endometrium; are high grade; are advanced stage, and do not respond to conventional chemotherapy, radiotherapy, and hormone therapy (4, 5). Recently, a dualistic model of carcinogenesis has been proposed on the basis of the distinctive clinical and histologic features of endometrioid and serous adenocarcinoma (6). Based on this model, UEA is associated with a slow, estrogen-driven model of carcinogenesis whereby unopposed estrogen stimulation leads to the sequential malignant transformation through a stage of atypical endometrial hyperplasia. In contrast, a p53-driven model of

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Uterine papillary serous carcinoma (UPSC) treated with cisplatin, doxorubicin, and cyclophosphamide (PAC)

Cited by 14 publications

References 0 publications

Discrimination between uterine serous papillary carcinomas and ovarian serous papillary tumours by gene expression profiling

Discrimination between uterine serous papillary carcinomas and ovarian serous papillary tumours by gene expression profiling

Uterine serous and grade 3 endometrioid carcinomas

Immunohistochemical Profile of Endometrial Adenocarcinoma: A Study of 61 Cases and Review of the Literature

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