title: [Clinicopathologic study on 61 cases of uterine papillary serous carcinoma with or without adjuvant therapy].
abstract: OBJECTIVE
  To study the clinicopathologic features of uterine papillary serous carcinoma (UPSC) and the roles of adjuvant therapy.
  
  
  METHODS
  Sixty-one cases of UPSC with operation done and followed up for a period of 4 to 9 years were enrolled into the study. The histology of slides specimens were reviewed and immunohistochemical study was performed. The follow-up and survival data were analyzed.
  
  
  RESULTS
  All of the 61 patients were post-menopausal, with a median age of 68 years. The clinical presentations included abnormal vaginal bleeding, abdominal symptoms and abnormal Pap smears. The median size of the tumors was 7.5 cm (range=1.2 to 14.8 cm). There were 27.9% cases in FIGO stage I (8.2% in stage IA, 14.8% in stage IB and 4.9% in stage IC), 9.8% in stage II, 32.8% in stage III and 29.5% in FIGO stage IV. The histologic features were similar to those of the ovarian counterpart, with tumor cells containing the high-grade nuclei and arranged in complex papillae. Psammoma bodies were identified in 24.6% of the cases. Immunohistochemical study showed that the tumor cells demonstrated diffuse and strong nuclear staining for p53 and Ki-67. They were negative for estrogen receptor and progesterone receptor. Fifteen of the 61 cases (24.6%) showed no evidence of myometrial invasion. However, ten of the 15 cases had extrauterine disease, with peritoneal (6/15) and nodal (9/15) involvement. Tumors with deep myometrial invasion, lymphovascular permeation and nodal metastasis were associated with worse prognosis by univariate analysis. Fifty-six patients received adjuvant therapy. The number of patients receiving adjuvant chemotherapy alone, adjuvant radiotherapy alone and combined adjuvant chemotherapy/radiotherapy were 42, 24 and 10, respectively. The median survivals of the chemotherapy group and non-chemotherapy group (with or without radiotherapy) were 66.4 months and 32.8 months, respectively.
  
  
  CONCLUSIONS
  UPSC has distinctive clinical and pathologic features. The tumor stage, lymph node status, lymphovascular permeation and depth of myometrial invasion were important prognostic factors. Adjuvant chemotherapy for stage III/IV tumors or recurrent UPSC may have survival benefit.
authors.affiliation: Depatment of Pathology, Ningbo Women and Children's Hospital, Ningbo 315012, China. abinxue@qq.com
authors.forename: De-bin
authors.initials: DB
authors.lastname: Xue
authors.forename: Li-juan
authors.initials: LJ
authors.lastname: Ding
authors.forename: Ai-li
authors.initials: AL
authors.lastname: Xia
authors.forename: Dong
authors.initials: D
authors.lastname: Chen
authors.forename: Hua-ping
authors.initials: HP
authors.lastname: Xia
authors.forename: Xiao-dong
authors.initials: XD
authors.lastname: Teng
authors.forename: Shao-ting
authors.initials: ST
authors.lastname: Xu
authors.forename: Suo-jiang
authors.initials: SJ
authors.lastname: Zhang
authors.forename: Xing-chang
authors.initials: XC
authors.lastname: Ren
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002291:Carcinoma, Papillary / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D018284:Cystadenocarcinoma, Serous / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008593:Menopause; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D017239:Paclitaxel / Q000008:administration & dosage; D018714:Radiotherapy, Adjuvant; D015996:Survival Rate; D014594:Uterine Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery
chemical_list: D017239:Paclitaxel; D002945:Cisplatin