The impact of combined radiation and chemotherapy on outcome in uterine papillary serous carcinoma compared to chemotherapy alone / 부인종양

OBJECTIVE: To investigate the impact of pelvic radiation on survival in patients with uterine serous carcinoma (USC) who received adjuvant chemotherapy. METHODS: Patients with stage I-IV USC were identified from the Surveillance, Epidemiology, and End Results program 2000 to 2009. Patients were included if treated with surgery and chemotherapy. Patients were divided into two groups: those who received chemotherapy and pelvic radiation therapy (CT_RT) and those who received chemotherapy only (CT). Kaplan-Meier curves and Cox regression proportional hazard models were used. RESULTS: Of the 1,838 included patients, 1,272 (69%) were CT and 566 (31%) were CT_RT. Adjuvant radiation was associated with significant improvement in overall survival (OS; p<0.001) and disease-specific survival (DSS; p<0.001) for entire cohort. These findings were consistent for the impact of radiation on OS (p<0.001) and DSS (p<0.001) in advanced stage (III-IV) disease but not for early stage (I-II) disease (p=0.21 for OS and p=0.82 for DSS). In multivariable analysis adjusting for age, stage, race and extent of lymphadenectomy, adjuvant radiation was a significant predictor of OS and DSS for entire cohort (p=0.003 and p=0.05) and in subset of patients with stage III (p=0.02 and p=0.07) but not for patients with stage I (p=0.59 and p=0.49), II (p=0.83 and p=0.82), and IV USC (p=0.50 and p=0.96). Other predictors were stage, positive cytology, African American race and extent of lymphadenectomy. CONCLUSION: In USC patients who received adjuvant chemotherapy, adjuvant radiation was associated with significantly improved outcome in stage III disease but not for other stages. Positive cytology, extent of lymphadenectomy and African race were significant predictors of outcome.

Significance of mutant p53, Ki-67, ER and PR in differential diagnosis of uterine endometrial carcinoma and uterine serous carcinoma / 肿瘤研究与临床

Objective To investigate the expression of mutant p53,Ki-67,ER and PR in uterine endometrial carcinoma and uterine serous carcinoma,and explore their significance in differential diagnosis.Methods The samples including 37 cases of uterine endometrial carcinoma and 37 cases of uterine serous carcinoma were analyzed.The expression of mutant p53,Ki-67,estrogen receptor and progesterone receptor were performed by using the immunocytochemical (IHC) EnVision system.Data were analyzed with SPSS 11.5 statistic software.Results The positive rate of mutant p53 in uterine endometrial carcinoma was statistically lower than that in uterine serous carcinoma [21.62 ％ (8/37) vs 64.86 ％ (24/37) (P ＜ 0.01)].The positive rate of Ki-67 in uterine endometrial carcinoma was statistically lower than that in uterine serous carcinoma [37.84 ％ (14/37) vs 70.27 ％ (24/37) (P ＜ 0.01)].The positive rate of estrogen receptor in uterine endometrial carcinoma was statistically higher than that in uterine serous carcinoma [78.38 ％ (29/37) vs 32.43 ％ (12/37) (P ＜ 0.01)].The positive rate of progesterone receptor in uterine endometrial carcinoma was statistically higher than that in uterine serous carcinoma [75.67 ％ (28/37) vs 29.73 ％ (11/37) (P ＜ 0.01)].Conclusions The expression of mutant p53 and Ki-67 are higher in uterine serous carcinoma.The expression of estrogen receptor and progesterone receptor are higher in uterine endometrial carcinoma.Combined detection of mutant p53,Ki-67,ER and PR has important significance in screening and preventing uterine endometrial carcinoma and uterine serous carcinoma.

A case of minimal uterine serous carcinoma with distant lymph node metastasis without peritoneal dissemination / 부인종양

A 61-year old woman underwent total abdominal hysterectomy and pelvic lymph node dissection under the diagnosis of endometrial cancer. Although pelvic lymph nodes were positive for adenocarcinoma with psamomma bodies, no other lesion that was a primary lesion was verified. A postoperative study revealed the existence of para-aortic lymph node and supraclavicular lymph node metastases. Therefore, the endometrial biopsy specimen was reviewed. With the findings of p53 positivity by immunohistochemistry in the papillary part, the final histopathological diagnosis was changed to endometrial serous adenocarcinoma. Postoperative chemotherapy followed by radiotherapy for supraclavicular lymph node metastasis achieved complete response. This type of tumor must be considered in a differential diagnosis when metastatic papillary serous carcinoma is detected, but the primary site remains unknown.