title: Treatment of early-stage uterine papillary serous carcinoma at Roswell Park Cancer Institute, 1992-2006.
abstract: OBJECTIVE
  Optimal management of early-stage uterine papillary serous carcinoma (UPSC) remains controversial. We reviewed our outcomes in this patient population.
  
  
  METHODS
  The Roswell Park Cancer Institute (RPCI) tumor registry identified all patients with Stages I and IIA UPSC treated between January 1992 and June 2006. The Fisher's exact test was used to compare recurrence rates by adjuvant therapy received. Overall survival (OS) estimates were made using the Kaplan-Meier method.
  
  
  RESULTS
  Fifty-eight patients with Stage I or IIA UPSC underwent surgery. Thirty-four patients (59%) were surgically staged. Among 21 patients with Stage IA disease, 15 received adjuvant therapy. With a median follow-up of 44.7 months, only one recurrence was observed in a patient who received adjuvant brachytherapy. The 5-year OS was 66%. Among 37 patients with Stages IB-IIA, 30 patients received adjuvant therapy. With a median follow-up of 29 months, there were 7 recurrences. The 5-year OS was 60%. Although there were no significant differences in recurrence by adjuvant therapy received, a significant OS benefit was found in those who received radiation. There was no significant difference in OS distributions of those patients who received Carboplatin/Paclitaxel chemotherapy.
  
  
  CONCLUSIONS
  Despite the limitations of our retrospective study, we have shown that even comprehensively staged early-stage UPSC patients are still at risk for recurrence despite adjuvant therapy received. Hence, all patients with this histologic diagnosis should be considered at high risk for recurrence and counseled appropriately regarding the risks and benefits of adjuvant therapy.
authors.affiliation: Division of Gynecologic Oncology, Department of Surgery, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA. Nana_Tchabo@yahoo.com
authors.forename: Nana E
authors.initials: NE
authors.lastname: Tchabo
authors.forename: Susan
authors.initials: S
authors.lastname: McCloskey
authors.forename: Terry L
authors.initials: TL
authors.lastname: Mashtare
authors.forename: Christopher
authors.initials: C
authors.lastname: Andrews
authors.forename: Anurag K
authors.initials: AK
authors.lastname: Singh
authors.forename: Paulette
authors.initials: P
authors.lastname: Mhawech-Fauceglia
authors.forename: Kunle
authors.initials: K
authors.lastname: Odunsi
authors.forename: Shashikant
authors.initials: S
authors.lastname: Lele
authors.forename: Wainwright
authors.initials: W
authors.lastname: Jaggernauth
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002291:Carcinoma, Papillary / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D018284:Cystadenocarcinoma, Serous / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*