The management of serous papillary uterine cancer

Abstract

Uterine papillary serous cancer is an extremely aggressive cancer, the optimum management of which is still being determined. It is important to understand advances that have been made in 2005 regarding the molecular biology, diagnosis, and management of this deadly disease. The main themes in the literature regarding uterine papillary serous cancer are that a potential precursor lesion, serous endometrial intraepithelial carcinoma, has been recognized as an early form of the disease. A variety of molecular biologically important markers have now been identified, including p53, HER2/neu, IL-6, kallikrein 6, and claudin-4, some of which may be susceptible to molecularly targeted therapy. Systematic surgical staging is necessary before additional therapy is recommended. Stage I uterine papillary serous cancer requires aggressive treatment, including surgery, chemotherapy, and radiation therapy for successful treatment. The most effective management of advanced stage disease remains to be resolved. Serous endometrial intraepithelial carcinoma should be treated as a form of uterine papillary serous cancer. Multimodality therapy is required for the successful management of early stage uterine papillary serous cancer. Advanced disease is often unresponsive to conventional therapy. Molecularly targeted therapies are now being introduced into the management of this disease.