Adjuvant therapy in early uterine serous carcinoma (324)

Abstract

<b>Objectives:</b> Uterine serous carcinomas represent approximately 10% of all endometrial cancers but are responsible for nearly 40% of all endometrial cancer-related deaths. Given the relatively low incidence of this disease, there are limited prospective data to guide adjuvant treatment decisions in early-stage disease. The purpose of this study was to evaluate the impact of adjuvant therapy on recurrence-free and overall survival in women with stage I-II pure uterine serous carcinoma. <b>Methods:</b> IRB approval was obtained. Using an institutional pathology database, we retrospectively identified all patients with 2009 FIGO stage I and II pure uterine serous carcinoma treated at a single institution from January 2006 to December 2019. Demographic, clinical-pathologic, treatment, and outcome data were collected using the electronic medical record. Serous histology was confirmed by a gynecologic pathologist, and only cases of pure uterine serous histology were included. Data were compared using descriptive statistics. Survival analyses were performed using Kaplan-Meier and Cox proportional hazard methods. <b>Results:</b> Ninety-four patients meeting inclusion criteria were identified with a median follow-up time of 33.5 months. The median age was 68 years (range: 49-87), the majority of patients were White (<i>n</i>=78, 83.0%), and the median BMI was 30.7 (range: 14.2-57.3). The minimally-invasive surgical staging was performed in 59.6% of cases (<i>n</i>=56). Most patients had stage IA disease (<i>n</i>=70, 74.5%), and lymphadenectomy was performed in 90.4% of cases (<i>n</i>=85). Most patients (<i>n</i>=79, 84.0%) received adjuvant therapy, and a majority of patients received a combination of systemic chemotherapy and radiation therapy (<i>n</i>=55, 58.5%), with the most common combination being chemotherapy plus vaginal brachytherapy (<i>n</i>=42, 44.7%). Most patients (<i>n</i>=77, 81.9%) remained without evidence of recurrent disease at the most recent follow-up, while 17 patients (18.1%) had experienced recurrence. Patients who received six cycles of adjuvant chemotherapy experienced improved overall survival (p=0.004) and improved recurrence-free survival (p=0.02) compared to those who received no adjuvant chemotherapy. <b>Conclusions:</b> Patients with surgically staged early pure serous uterine carcinoma who received six cycles of adjuvant chemotherapy had significantly improved overall and recurrence-free survival compared to those who did not receive adjuvant chemotherapy.