ABSTRACT
Uterine papillary serous cancer [UPSC] represents only 10% of all uterine cancers and is associated with a significantly worse prognosis compared with other histological types of endometrial cancers. It closely resembles the behavior of ovarian carcinoma. Retrospective study in a referral center covering period from February 1989 to January 2009.Eighteen patients who underwent definitive surgery followed by adjuvant therapy-platinum-based chemotherapy, radiotherapy, or both-were reviewed. Median age was 62 years [range, 52-76 years]. All patients underwent total abdominal hysterectomy and salpingo-oophorectomy. Positive lymph nodes were found in 4 of 7 patients who underwent lymph node sampling/dissection. Seven patients had stage I/II disease, whereas 11 patients had stage III disease. Six patients received chemotherapy, 5 patients received radiation therapy, while 7 patients received both chemotherapy and radiation therapy. Median follow-up was 27 months. The median survival and relapse-free survival were 33 and 23 months, respectively. Eight patients were alive and free of disease, of whom 5 patients were stage I/II and 4 patients were stage III. Distant metastasis was the most common site of relapse. Early stage [I/II] was associated with significant improvement in relapse-free survival [RFS] and overall survival [OS] [P=.004 and P=.05, respectively]. The combined-modality treatment including chemotherapy-radiotherapy showed statistically significant improvement in RFS [P=.012], while the improvement in OS did not reach statistical significance [P=.12].This study indicates that postoperative combined treatment with chemotherapy and radiation therapy plays a role in the management of UPSC by improving RFS. Distant metastasis remains the major site of relapse. Future studies using combined-modality therapy are needed to improve the outcome in patients with UPSC