title: Significance of comprehensive surgical staging in noninvasive papillary serous carcinoma of the endometrium.
abstract: OBJECTIVE
  To evaluate the biological behavior of noninvasive papillary serous carcinoma of the endometrium. METHODS; From 1990 to 2001, all women with noninvasive uterine papillary serous carcinoma (UPSC) at three Southern California hospitals were identified from tumor registry databases. Data for analysis were collected from hospital charts, office records, and tumor registry files.
  
  
  RESULTS
  Of the 100 patients diagnosed with UPSC, 16 had noninvasive lesions. Twelve underwent a comprehensive surgical staging procedure with omental resection. Six of these 12 women were found to have disease beyond the uterine corpus, including 4 with adnexal involvement, 3 with omental disease, 2 with cervical extension, 1 with pelvic lymph node involvement, and 3 with positive washings. Three women were found to have positive cytology and metastases in more than one location. Of the 12 patients, 1 of the 6 with stage IA disease had distant recurrence and 4 of the 6 with stage II-IV disease recurred. Of the remaining 4 patients who underwent a staging procedure without pathologic omental assessment, 1 was found to have cervical extension. In these 4 women, 1 with stage IA disease recurred.
  
  
  CONCLUSIONS
  The typical patterns of spread and prognostic factors for endometrioid carcinoma of the uterus do not apply to UPSC. In our series, omental assessment was necessary to detect the 25% of patients with stage IVB disease due to omental involvement. Thus, women with noninvasive UPSC should undergo a comprehensive staging procedure including omental sampling to determine the extent of disease.
authors.affiliation: Department of Obstetrics and Gynecology, University of California, Irvine-Medical Center, 101 The City Drive, Orange, CA 92868, USA.
authors.forename: John K
authors.initials: JK
authors.lastname: Chan
authors.forename: Vera
authors.initials: V
authors.lastname: Loizzi
authors.forename: Mark
authors.initials: M
authors.lastname: Youssef
authors.forename: Kathryn
authors.initials: K
authors.lastname: Osann
authors.forename: Joanne
authors.initials: J
authors.lastname: Rutgers
authors.forename: Steven A
authors.initials: SA
authors.lastname: Vasilev
authors.forename: Michael L
authors.initials: ML
authors.lastname: Berman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018283:Cystadenocarcinoma, Papillary / Q000473:pathology* / Q000601:surgery*; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging