Outcome Determinants in Uterine Papillary Serous Carcinoma Based on Clinicopathological and Treatment Factors

Abstract

Purpose/Objective(s): Stage II endometrial cancer is relatively uncommon. There is no consensus for appropriate adjuvant therapy in endometrial cancer patients with cervical stromal involvement (FIGO stage II). This study investigates how adjuvant treatments and tumor characteristics influence OS and DFS in stage II patients in order to establish better treatment guidelines. Materials/Methods: This multi-institution, IRB approved, study is a retrospective review of 40 surgically staged endometrial cancer patients with cervical stromal involvement treated from 1993 to 2009. KaplanMeier estimates were used to evaluate OS and DFS. Results: The average age for all patients was 61 (36-83). Patient OS was 85% at three years and 67% at five years. There were no significant differences in age, histology, depth of invasion, comorbid conditions, surgical staging or recurrence between patients who received RT and those who did not receive RT. However, patients with FIGO grade 1 cancers were less likely to receive RT (p<0.007). Patients treated with RT had a similar 5 year OS (nZ33, 69%) to those treated with surgery only (nZ7, 60%, pZ0.7462). There were no OS differences when evaluating by grade, histology, or depth of invasion between patients who did and did not receive RT. Four patients recurred out of the 40 who were treated. Patient, tumor and treatment characteristics are outlined in table 1. Three were local recurrences, and one presented with concurrent local and distant failure. Our only vaginal cuff recurrence had a grade 1 tumor and had not received adjuvant RT, but was salvaged with RT in a timely manner after the recurrence. The remaining three recurrences occurred in patients who received radiation near the time of surgery, and all died from complications related to their cancer after recurrence. Conclusions: In this retrospective series, patients receiving RT had higher grade tumors. Despite this, OS was comparable between the RT and the no RT cohorts. Endometrial cancer patients with cervical stromal involvement likely receive better locoregional control with the addition of adjuvant RT, and we continue to advocate for RT in most cases. Author Disclosure: J. Frandsen: None. W.T. Sause: None. M.K. Dodson: None. A.P. Soisson: None. T.W. Belnap: None. D.K. Gaffney: None.