J Gynecol Oncol.  2018 May;29(3):e34. 10.3802/jgo.2018.29.e34.

Prognostic factors for patients with early-stage uterine serous carcinoma without adjuvant therapy

• Tate K
• Yoshida H
• Ishikawa M
• Uehara T
• Ikeda SI
• Hiraoka N
• Kato T

• KMID: 2409935
• DOI: http://doi.org/10.3802/jgo.2018.29.e34

Abstract

OBJECTIVE
Uterine serous carcinoma (USC) is an aggressive type 2 endometrial cancer. Data on prognostic factors for patients with early-stage USC without adjuvant therapy are limited. This study aims to assess the baseline recurrence risk of early-stage USC patients without adjuvant treatment and to identify prognostic factors and patients who need adjuvant therapy.
METHODS
Sixty-eight patients with International Federation of Gynecology and Obstetrics (FIGO) stage I-II USC between 1997 and 2016 were included. All the cases did not undergo adjuvant treatment as institutional practice. Clinicopathological features, recurrence patterns, and survival outcomes were analyzed to determine prognostic factors.
RESULTS
FIGO stages IA, IB, and II were observed in 42, 7, and 19 cases, respectively. Median follow-up time was 60 months. Five-year disease-free survival (DFS) and overall survival (OS) rates for all cases were 73.9% and 78.0%, respectively. On multivariate analysis, cervical stromal involvement and positive pelvic cytology were significant predictors of DFS and OS, and ≥1/2 myometrial invasion was also a significant predictor of OS. Of 68 patients, 38 patients had no cervical stromal invasion or positive pelvic cytology and showed 88.8% 5-year DFS and 93.6% 5-year OS.
CONCLUSION
Cervical stromal invasion and positive pelvic cytology are prognostic factors for stage I-II USC. Patients with stage IA or IB USC showing negative pelvic cytology may have an extremely favorable prognosis and need not receive any adjuvant therapies.

Keyword

Adenocarcinoma; Endometrial Neoplasms; Prognosis; Cytodiagnosis; Chemotherapy, Adjvant

MeSH Terms

Adenocarcinoma
Cytodiagnosis
Disease-Free Survival
Endometrial Neoplasms
Female
Follow-Up Studies
Gynecology
Humans
Institutional Practice
Multivariate Analysis
Obstetrics
Prognosis
Recurrence