Uterine Papillary Serous Carcinoma—Still an Enigma?

被引:1
作者
Sumangala G. [1 ]
Premalatha T.S. [1 ]
Kulkarni K.A. [1 ]
Acharya G. [1 ]
Bidkar V.C. [1 ]
Crasta J. [2 ]
Vallikad E. [1 ]
机构
[1] Department of Gynaecologic Oncology, St. John’s Medical College, Sarjapur Road, Bangalore
[2] Department of Pathology, St. John’s Medical College, Bangalore
关键词
Chemotherapy; Endometrial cancer; Radiotherapy; Uterine papillary serous carcinoma;
D O I
10.1007/s40944-017-0102-8
中图分类号
学科分类号
摘要
Purpose: Uterine papillary serous carcinoma (UPSC) accounts for 10–15% of all endometrial carcinomas. Poor outcome is because of higher stage at presentation and relapse in the upper abdomen. The purpose of this study was to analyse clinical and surgico-pathological features of UPSC. Methods: Data was retrieved from medical records of patients with UPSC between March 2013 and August 2016. Patients underwent surgical staging or received neoadjuvant chemotherapy (NACT) in inoperable cases. Myometrial invasion (MI), lymphovascular invasion (LVSI) and metastases to lymph nodes were noted. Patients were staged according to FIGO 2009. Adjuvant chemotherapy (paclitaxel, carboplatin and epirubicin) with or without adjuvant radiotherapy was given. Survival was noted on follow-up. Results: Ten patients were identified with UPSC. Complete surgical staging in five of ten and NACT in two patients were given. FIGO stage IA was observed in one patient and three each in IIIC2, IVB and stage unknown. MI of more than 50% in eight, LVSI in seven and lymph node metastases in five patients were seen. Adjuvant chemotherapy was received by nine and adjuvant radiotherapy in three patients. Two patients expired within 6 and 8 months after therapy. One patient had intra-abdominal recurrence 2 years after treatment. Conclusion: Complete cytoreductive surgery followed by adjuvant platinum-/taxane-based chemotherapy with or without adjuvant radiotherapy should be the choice of treatment. Multi-centre collaborative studies are required in aiding treatment. © 2017, Association of Gynecologic Oncologists of India.
引用
收藏
相关论文
共 37 条
[1]  
Boruta D.M., Gehrig P.A., Fader A.N., Olawaiye A.B., Management of women with uterine papillary serous cancer. Society of Gynecologic Oncology (SGO) review, Gynecol Oncol, 115, pp. 142-143, (2009)
[2]  
Greggi S., Mangili G., Scaffa C., Scala F., Losito S., Iodice F., Pisano C., Montoli S., Vigano R., Pirozzi G., Giannarelli D., Uterine papillary serous, clear cell, and poorly differentiated endometrioid carcinomas: a comparative study, Int J Gynecol Cancer, 21, pp. 661-667, (2011)
[3]  
Hamilton C.A., Cheung M.K., Osann K., Chen L., Teng N.N., Longacre T.A., Powell M.A., Hendrickson M.R., Kapp D.S., Chan J.K., Uterine papillary serous and clear cell carcinomas predict for poorer survival compared to grade 3 endometrioid corpus cancers, Br J Cancer, 94, 5, pp. 642-646, (2006)
[4]  
Cirisano F.D., Robboy S.J., Dodge R.K., Bentley R.C., Krigman H.R., Synan I.S., Et al., Epidemiologic and surgicopathologic findings of papillary serous and clear cell endometrial cancers when compared to endometrioid carcinoma, Gynecol Oncol, 74, (1999)
[5]  
Hendrickson M., Ross J., Eifel P., Martinez A., Kempson R., Uterine papillary serous carcinoma: a highly malignant form of endometrial adenocarcinoma, Am J Surg Pathol, 6, pp. 93-98, (1982)
[6]  
Mendivil A., Schuler K.M., Gehrig P.A., Non-endometrioid adenocarcinoma of the uterine corpus: a review of selected histological subtypes, Cancer Control, 16, (2009)
[7]  
Goff B.A., Kato D., Schmidt R.A., Ek M., Ferry J.A., Muntz H.G., Et al., Uterine papillary serous carcinoma: patterns of metastatic spread, Gynecol Oncol, 54, pp. 264-268, (1994)
[8]  
Nielsen S.N., Podratz K.C., Scheithauer B.W., O'Brien P.C., Clinicopathologic analysis of uterine malignant mixed mullerian tumors, Gynecol Oncol, 34, pp. 372-378, (1989)
[9]  
Murphy K.T., Rotmensch J., Yamada S.D., Mundt A.J., Outcome and patterns of failure in pathologic stages I–IV clear-cell carcinoma of the endometrium: implications for adjuvant radiation therapy, Int J Radiat Oncol Biol Phys, 55, pp. 1272-1276, (2003)
[10]  
Fields A.L., Einstein M.H., Novetsky A.P., Gebb J., Goldberg G.L., Pilot phase II trial of radiation “sandwiched” between combination paclitaxel/platinum chemotherapy in patients with uterine papillary serous carcinoma (UPSC), Gynecol Oncol, 108, pp. 201-206, (2008)