title: Optimal surgical debulking in uterine papillary serous carcinoma affects survival.
abstract: OBJECTIVE
  UPSC is similar to papillary serous ovarian carcinoma in its histology and pattern of spread. The survival advantage with optimal debulking for ovarian cancer has been demonstrated. We examined our experience with UPSC.
  
  
  METHODS
  Seventy-eight UPSC patients were seen between 1995 and 2008 at Rush University Medical Center for surgery and/or adjuvant treatment. Information was obtained retrospectively from the Rush computer system, National Death Registry, and charts from chemotherapy, radiation, and gynecologic oncology.
  
  
  RESULTS
  Mean survival was 67.1 months for all stages (95% CI 52.8-81.2), 47.6 months for stage III (95% CI 26.7-68.3), and 21.7 months for stage IV (95% CI 14.5-29.1). No deaths occurred in stages I and II. No significant survival difference was found between African-Americans and Whites (log-rank test, p=0.62), nor between full serous and mixed pathology (log-rank test, p=0.52). Optimally debulked stage IV patients had a mean survival of 30.9 months, compared to 10.3 months in suboptimally debulked patients (p<0.001). Optimal debulking had no significant effect on stage III survival (p=0.47). Although weight was not statistically significant (p=0.059), there was a trend associated with suboptimal debulking. The mean time to recurrence for stage I was 79.9 months (95% CI 12.8-54.9), stage III was 27.4 months (95% CI 7.8-47.1), and stage IV was 20.2 months (95% CI 11.1-29.4) (p<0.001). There were no recurrences in stage II.
  
  
  CONCLUSIONS
  Our results suggest that UPSC should be optimally debulked. Weight is a risk factor for suboptimal debulking, which decreases mean survival and time to recurrence.
authors: Department of Obstetrics and Gynecology, Rush University Medical Center, 600 South Paulina, Chicago, IL 60612, USA.
authors: Kristia
authors: K
authors: Patsavas
authors: Jessica
authors: J
authors: Woessner
authors: Benjamin
authors: B
authors: Gielda
authors: Jacob
authors: J
authors: Rotmensch
authors: Edgardo
authors: E
authors: Yordan
authors: Pincas
authors: P
authors: Bitterman
authors: Alfred
authors: A
authors: Guirguis
mesh_terms: D000368:Aged; D002291:Carcinoma, Papillary / Q000208:ethnology / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D018284:Cystadenocarcinoma, Serous / Q000208:ethnology / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000208:ethnology / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000208:ethnology / Q000473:pathology; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D015996:Survival Rate