title: Evaluation of adjuvant therapy in women with uterine papillary serous cancer.
abstract: Uterine papillary serous cancer (UPSC) represents only 10% of all uterine cancers and is associated with a significantly worse prognosis compared with other histological types of endometrial cancers. It closely resembles the behavior of ovarian carcinoma.
  
  
  
  Retrospective study in a referral center covering period from February 1989 to January 2009.
  
  
  
  Eighteen patients who underwent definitive surgery followed by adjuvant therapy-platinum-based chemotherapy, radiotherapy, or both-were reviewed. Median age was 62 years (range, 52-76 years). All patients underwent total abdominal hysterectomy and salpingo-oophorectomy. Positive lymph nodes were found in 4 of 7 patients who underwent lymph node sampling/dissection. Seven patients had stage I/II disease, whereas 11 patients had stage III disease. Six patients received chemotherapy, 5 patients received radiation therapy, while 7 patients received both chemotherapy and radiation therapy.
  
  
  
  Median follow-up was 27 months. The median survival and relapse-free survival were 33 and 23 months, respectively. Eight patients were alive and free of disease, of whom 5 patients were stage I/II and 4 patients were stage III. Distant metastasis was the most common site of relapse. Early stage (I/II) was associated with significant improvement in relapse-free survival (RFS) and overall survival (OS) (P=.004 and P=.05, respectively). The combined-modality treatment including chemotherapy-radiotherapy showed statistically significant improvement in RFS (P=.012), while the improvement in OS did not reach statistical significance (P=.12).
  
  
  
  This study indicates that postoperative combined treatment with chemotherapy and radiation therapy plays a role in the management of UPSC by improving RFS. Distant metastasis remains the major site of relapse. Future studies using combined-modality therapy are needed to improve the outcome in patients with UPSC.
authors.affiliation: Department of Medical Oncology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. helmyalaa@hotmail.com
authors.forename: Hamed
authors.initials: H
authors.lastname: Al Husaini
authors.forename: Hussein
authors.initials: H
authors.lastname: Soudy
authors.forename: Alaa
authors.initials: A
authors.lastname: Darwish
authors.forename: Mohamed
authors.initials: M
authors.lastname: Ahmed
authors.forename: Amin
authors.initials: A
authors.lastname: Eltigani
authors.forename: Wael
authors.initials: W
authors.lastname: Edesa
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Abdelsalam
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D018284:Cystadenocarcinoma, Serous / Q000628:therapy*; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000628:therapy*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D010052:Ovariectomy; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D058994:Salpingectomy; D016896:Treatment Outcome