Tumor Recurrence Rate and Survival Outcomes of Uterine Serous Carcinoma after Surgical Treatment

Abstract

Background: Uterine serous carcinoma is a rare histologic subtype of endometrial cancer. Oncologic outcomes for this disease are sparsely reported, and adjuvant therapy after surgery is considerably heterogeneous. Objective: To determine the 2-year recurrence rate, recurrence-free survival, overall survival, and associated factors among patients with uterine serous carcinoma after surgical treatment at Siriraj Hospital. Materials and Methods: One hundred thirty uterine serous carcinoma patients diagnosed between December 2007 and June 2015 were enrolled. Patients who did not undergo surgery as a primary treatment or not achieve clinically complete response were excluded. Pathological slides were reviewed. Data were retrieved from the medical records including gynecologic data, surgical and pathological results, post-operative treatment, response status, recurrence status, and follow-up data. The recurrence rate at two years was calculated. Recurrence-free survival and overall survival were analyzed, and various characteristics were used to determine associated treatment outcomes. Results: One hundred nine patients were analyzed, 50 in stage I, 15 in stage II, 38 in stage III, and six in stage IV. Median follow-up time was 23 months. At two years, the recurrence rate was 35.8%. Post-operative treatment was performed in 91.7%, and chemotherapy was the most common modality used. Eleven patients (16.9%) in early-stage and twenty-five patients (56.8%) in the advanced stage had disease recurrence. Thirty patients (83.3%) had disease recurrence intra-abdominal or multiple metastases. No patient in stage I that received adjuvant chemotherapy had relapsed disease. Two-year recurrence-free survival and 2-year overall survival were 71.2% and 83.4%, respectively. FIGO staging was the only factor associated with recurrence-free survival. Conclusion: Uterine serous carcinoma represents a rare disease with a high recurrence rate and poor prognosis. FIGO staging is related to recurrence-free survival. Adjuvant chemotherapy showed survival benefits in early-stage uterine serous carcinoma. Keywords: Uterine serous carcinoma, Adjuvant therapy, Recurrence, Survival