title: Impact of adjuvant therapy on survival of patients with early-stage uterine papillary serous carcinoma.
abstract: OBJECTIVE
  To determine the efficacy of adjuvant therapy in patients with early-stage uterine papillary serous carcinoma.
  
  
  METHODS
  Data were collected on all surgically staged Stage I-II uterine papillary serous carcinoma patients. Statistical analyses were performed using the Kaplan-Meier and Cox proportional hazards regression methods.
  
  
  RESULTS
  Of 68 patients, 50 had Stage I and 18 had Stage II disease; 35 underwent adjuvant treatment, including radiotherapy in 26, chemotherapy in 7, and combined RT and chemotherapy in 2. The remaining 33 were treated expectantly. The median follow-up was 56 months (range 1-173). The 5-year overall survival rate was 69%. Of 19 patients with disease limited to the endometrium, 10 received no additional therapy, 3 of whom developed recurrence. However, all 9 women who underwent adjuvant treatment remained free of disease. Patients receiving adjuvant therapy with chemotherapy or radiotherapy had a prolonged 5-year overall and disease-free survival compared with those who were treated expectantly (85% vs. 54%, p = 0.002 for overall survival and 85% vs. 49%, p = 0.01 for disease-free survival). In multivariate analysis, adjuvant therapy (p = 0.035) and the absence of lymphovascular space invasion (p = 0.001) remained as independent prognostic factors for improved survival.
  
  
  CONCLUSIONS
  Adjuvant therapy with chemotherapy or radiotherapy improves the survival of women with early-stage uterine papillary serous carcinoma.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA 94305, USA.
authors.forename: Chad A
authors.initials: CA
authors.lastname: Hamilton
authors.forename: Wen-Shiung
authors.initials: WS
authors.lastname: Liou
authors.forename: Kathryn
authors.initials: K
authors.lastname: Osann
authors.forename: Michael L
authors.initials: ML
authors.lastname: Berman
authors.forename: Amreen
authors.initials: A
authors.lastname: Husain
authors.forename: Nelson N
authors.initials: NN
authors.lastname: Teng
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Kapp
authors.forename: John K
authors.initials: JK
authors.lastname: Chan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016190:Carboplatin / Q000008:administration & dosage; D017024:Chemotherapy, Adjuvant; D018283:Cystadenocarcinoma, Papillary / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D004317:Doxorubicin / Q000008:administration & dosage; D016889:Endometrial Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D017239:Paclitaxel / Q000008:administration & dosage; D018714:Radiotherapy, Adjuvant; D012044:Regression Analysis; D015996:Survival Rate
chemical_list: D004317:Doxorubicin; D016190:Carboplatin; D017239:Paclitaxel