title: The role of radiotherapy in the management of resected uterine papillary serous and clear cell carcinoma.
abstract: OBJECTIVE
  Primary uterine papillary serous (PS) and clear cell (CC) carcinoma are aggressive histologies characterized by elevated risk of loco-regional recurrence and disease-specific mortality following hysterectomy. The impact of adjuvant radiotherapy remains to be elucidated. The present study is a single institution, retrospective cohort comparison to determine whether post-hysterectomy radiotherapy improves loco-regional control and/or disease-specific survival outcomes in a population of women with PS and/or CC.
  
  
  METHODS
  Between June 1992 and November 2006, 50 women underwent hysterectomy alone (H) or hysterectomy with adjuvant radiotherapy (H+RT) for primary uterine PS and/or CC. RT involved either high dose-rate (HDR) brachytherapy, external beam RT, or both.
  
  
  RESULTS
  At a median survivor follow-up of 27 months (range 2.7-137.3) for the H+RT group and 61 months (range 11.9-114.6) for the H group (range 3-137), patients in the H+RT group demonstrated a trend toward superior disease-free survival (not yet attained at 26 months versus 25 months; p=0.0625). For patients with > or =24 months of follow-up, disease recurrence was significantly higher in H patients over H+RT patients (45% versus 12.5%; p<0.05). Additionally, the H+RT group demonstrated significant improvement in loco-regional control (0% versus 37.5%; p<0.001), most pronounced within FIGO stages I-II H+RT patients (0% versus 70%; p<0.001). Overall survival was not significantly different between the two cohorts (H=32 months, H+RT=not yet attained at 26 months; p=non-significant).
  
  
  CONCLUSIONS
  Hysterectomy with adjuvant radiotherapy significantly improves disease-free survival within 2 years post-hysterectomy and significantly reduces loco-regional failures over hysterectomy alone.
authors.affiliation: Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC 29425, USA. batchele@musc.edu
authors.forename: Emma C
authors.initials: EC
authors.lastname: Batchelor
authors.forename: John M
authors.initials: JM
authors.lastname: Watkins
authors.forename: William T
authors.initials: WT
authors.lastname: Creasman
authors.forename: Matthew F
authors.initials: MF
authors.lastname: Kohler
authors.forename: Debajyoti
authors.initials: D
authors.lastname: Sinha
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Jenrette
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000532:radiotherapy* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003131:Combined Modality Therapy; D018283:Cystadenocarcinoma, Papillary / Q000532:radiotherapy* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D014594:Uterine Neoplasms / Q000532:radiotherapy / Q000601:surgery