What Has Changed in the Management of Uterine Serous Carcinomas? Two Decades of Experience.

Michalis Liontos,Angeliki Andrikopoulou,Oraianthi Fiste,Alexandros Rodolakis,Nikolaos Thomakos,Konstantinos Koutsoukos,Maria Kaparelou,Dimitrios Haidopoulos,Charalampos Theofanakis,Flora Zagouri,Anna Svarna,Meletios Athanasios Dimopoulos

doi:10.3390/curroncol28060410

Michalis Liontos, Angeliki Andrikopoulou + Show 10 more

Open Access

https://doi.org/10.3390/curroncol28060410

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Abstract

Uterine serous carcinoma accounts for 3–10% of endometrial cancers, but it is the most lethal histopathological subtype. The molecular characterization of endometrial carcinomas has allowed novel therapeutic approaches for these patients. We undertook a retrospective analysis of patients with uterine serous carcinomas treated in our hospital within the last two decades to identify possible changes in their management. The patients and their characteristics were evenly distributed across the two decades. Treatment modalities did not change significantly throughout this period. After adjuvant treatment, patients’ median disease-free survival was 42.07 months (95% CI: 20.28–63.85), and it did not differ significantly between the two decades (p = 0.059). The median overall survival was 47.51 months (95% Cl: 32.18–62.83), and it significantly favored the first decade’s patients (p = 0.024). In patients with de novo metastatic or recurrent disease, median progression-free survival was 7.8 months (95% Cl: 5.81–9.93), whereas both the median progression-free survival and the median overall survival of these patients did not show any significant improvement during the examined time period. Overall, the results of our study explore the minor changes in respect of uterine serous carcinoma’s treatment over the last two decades, which are reflected in the survival outcomes of these patients and consequently underline the critical need for therapeutic advances in the near future.

Highlights

Endometrial cancer is the most frequent gynecological cancer in developed countries.According to the American Cancer Society (ACS), more than 65,000 women will be diagnosed and about 12,500 will eventually die from this disease in 2021
No statistically significant differences were found between the baseline characteristics of patients diagnosed in the 1st decade (1999–2009) and the 2nd decade (2010–2019) of our study (Table 1)
We showed that patients and their characteristics were evenly distributed over the two decades, and treatment modalities did not change significantly throughout this period

Summary

Introduction

Endometrial cancer is the most frequent gynecological cancer in developed countries. According to the American Cancer Society (ACS), more than 65,000 women will be diagnosed and about 12,500 will eventually die from this disease in 2021. Women aged 60 to 70 are primarily in peril, with 95–98% of tumors affecting women above the age of 40 [1]. The most common histological type is endometrioid at about 85%, while the serous type of uterine carcinomas (USC) comes far second, at a rate of 3–10% of all cases [2]. Despite the small percentage of women carrying this histological subtype, a disproportionate number of them will succumb compared to the endometrioid type group. Approximately 40% of uterine cancer-related deaths are attributed to the serous variant [3]

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