Prognosis for papillary serous carcinoma of the endometrium after surgicalstaging

Citation
Np. Nguyen et al., Prognosis for papillary serous carcinoma of the endometrium after surgicalstaging, INT J GYN C, 11(4), 2001, pp. 305-311
Citations number
36
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Reproductive Medicine
Journal title
INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER
ISSN journal
1048-891X → ACNP
Volume
11
Issue
4
Year of publication
2001
Pages
305 - 311
Database
ISI
SICI code
1048-891X(200107/08)11:4<305:PFPSCO>2.0.ZU;2-0
Abstract
Background: To investigate the pattern of failure and the prognosis followi ng pathological staging for uterine papillary serous carcinoma (UPSC). Patients and methods: A retrospective review was conducted of 22 patients w ith UPSC, treated between 1989 and 1998 at a single institution. All patien ts were surgically staged. Two patients with advanced disease received chem otherapy only. Two patients with early-stage disease were followed without further treatment. Eighteen patients received postoperative irradiation; ei ght patients received whole abdominal irradiation (WART), and the remaining 10 patients, pelvic irradiation (PRT). In addition, seven of these patient s received vaginal cuff irradiation with low-dose-rate or high-dose-rate br achytherapy. Toxicity, pattern of failure, and survival were evaluated and compared to the literature. Results: Seven patients (32%) developed distant metastases, three out of se ven (42%) after WART. Four out of seven patients who had distant metastases died from disease progression during subsequent chemotherapy. All patients with distant metastases had locally advanced-stage disease at presentation (six stage III, one stage IV). Four patients with pelvic recurrences devel oped concurrent (2) and subsequent (2) distant metastases. Three patients h ad isolated distant metastases. No patient with early stage-disease (stage I and II) died from disease progression. Conclusion: Pathological staging should be performed for all patients with UPSC to determine the prognosis as well as to tailor the treatment. The rol e of abdominal irradiation in the treatment of UPSC is yet to be determined ; however, such an approach may not be necessary for the control of disease for patients with early-stage (I and II) disease. Patients with locally ad vanced-stage (stage III) disease are at risk of local regional failures and distant metastases despite WART. Therefore, the benefit of WART for advanc ed-stage disease is also questionable. Paclitaxel-based chemotherapy is cur rently being investigated in this setting.