title: Role of adjuvant chemotherapy in patients with early stage uterine papillary serous cancer.
abstract: OBJECTIVE
  Uterine papillary serous carcinoma (UPSC) is an aggressive subtype of endometrial cancer. We studied survival outcomes in patients with stages I/II UPSC.
  
  
  METHODS
  A retrospective, multi-institutional study of patients with stages I/II UPSC was conducted. Patients underwent surgical staging followed by observation, adjuvant platinum-based chemotherapy (CT), or radiation therapy (RT). Continuous variables were compared via Wilcoxon rank sum test; Fisher exact test was used for the unordered categorical variables. Kaplan-Meier curves were used to estimate survival.
  
  
  RESULTS
  Thirty-nine women were diagnosed with stage I (n = 30) or II (n = 9) UPSC, with a median follow-up of 52 months. Of the 26 patients who did not receive adjuvant CT, 9 developed recurrences and 8 died of their disease. Of the 10 patients with no myometrial invasion who did not receive adjuvant CT, 3 developed recurrences and died. Of the 7 patients who underwent RT, 2 developed distant recurrences and died. Of the 13 patients who underwent CT, 1 developed vaginal recurrence. The 5-year overall (OS) and progression-free survival (PFS) rates for the adjuvant CT group were 100% and 92%, respectively, compared with 69% and 65% for those who did not receive CT (P = 0.002 OS, P = 0.002 PFS). The 5-year OS and PFS rates for RT group were both 71%.
  
  
  CONCLUSIONS
  Patients with stages I/II UPSC are at significant risk for distant recurrence and poor survival. Platinum-based adjuvant CT may decrease recurrence rate and improve survival in women with early and well-staged UPSC.
authors: Division of Gynecologic Oncology, University of California Irvine, Orange, CA, USA. ali.mahdavi@aurora.org
authors: Ali
authors: A
authors: Mahdavi
authors: Tania R
authors: TR
authors: Tajalli
authors: Ahmed
authors: A
authors: Dalmar
authors: Steven A
authors: SA
authors: Vasilev
authors: Scott E
authors: SE
authors: Lentz
authors: Michael L
authors: ML
authors: Berman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002140:California / Q000453:epidemiology; D016190:Carboplatin / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D018283:Cystadenocarcinoma, Papillary / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D017239:Paclitaxel / Q000627:therapeutic use*; D012189:Retrospective Studies; D014594:Uterine Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery
chemical_list: D000970:Antineoplastic Agents; D016190:Carboplatin; D017239:Paclitaxel