The role of abdominal-pelvic radiotherapy in the management of uterine papillary serous carcinoma.
OBJECTIVE
To evaluate the role of abdominal-pelvic radiotherapy (APR) as adjuvant treatment for uterine papillary serous carcinoma (UPSC).


METHODS
The medical records database at the Toronto-Sunnybrook Regional Cancer Centre identified 121 patients with the diagnosis of UPSC between 1980 and 2001. Fifty-nine patients received APR as adjuvant treatment. A retrospective chart review was done to evaluate recurrence rates, sites of failure, and treatment toxicity.


RESULTS
Of 59 patients who received APR, 30 had advanced-stage disease (Stage III or IV). Eleven had complete surgical staging. Median follow-up was 71 months. Twenty-five of 59 (42%) recurred, with a median time to relapse of 50 months. Five-year disease-free survival was 43%, and 5-year overall survival was 45%. Of the 25 who recurred, only 3 experienced a sole failure outside the irradiated volume. Thirteen women had their treatment interrupted or discontinued because of toxicity.


CONCLUSIONS
This single-institution study reveals that there is a high recurrence rate despite APR, especially among patients with advanced stage disease, and the majority of recurrences continue to be within the irradiated volume. The role of APR remains undefined in early disease but its effectiveness is questionable in advanced disease. Innovative strategies are needed to improve outcome in these patients.
Division of Gynecologic Oncology, University of Toronto, Toronto, Ontario, Canada.
Janice
J
Kwon
Ida
I
Ackerman
Edmee
E
Franssen
D000005:Abdomen; D000368:Aged; D000369:Aged, 80 and over; D018283:Cystadenocarcinoma, Papillary / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D018284:Cystadenocarcinoma, Serous / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D010388:Pelvis; D011878:Radiotherapy / Q000379:methods; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D014594:Uterine Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery